Laserfiche WebLink
<br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />.'._ <br />Sample Submittal 525662 <br />C: P.O., Box 1750 S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Canon City, CO 81215 Nucla, CO 81424 . <br />Sample Loc./ID No. A ov/ Lab..No.(s) <br />Sample Date?-/ Time f C1 <br />Collected By 13 d ???.? r- ?.? <br />Field Custodian AZ) ?? .?... ?- <br />Delivered By <br />Received By <br />Date Recd. <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />f <br />j? k-2 ? 26 U;k` <br />Jor <br />Time Recd. L ? .o <br />1. <br />2. <br />Sample Type: Air Water Soil Other (specify): <br />Analysis - Test series requested:o r?O f <br />3. Field Data - Preservation: <br /> <br />ti <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS - Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC <br />Date <br />Page 37 of 43 <br />??5 x- 5c ?.v -°"-y.a.=:»-?YU=_'- '? - •., a-:_ ,3ic:" ,3:.?"s?3 '_. ]'J.d.9s.4?.... .x ., . ..: .-.., ?-6o..ao?.?.?:siw ?'bi44