Laserfiche WebLink
r. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal _ `:? S ? -82 <br />C: P.O. Box 1750 . S: P.O. Box 1750 <br />Canon City, CO 81215 Canon City, CO 81215 <br />Sample.LocJID No.. Lab. No.(s) <br />Sample Date Time S? <br />Collected 'BY <br />.<< ' f •..-e.,, r ,r," <br />Field Custodian:?fw <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />L. <br />V <br />Kl- WIN-019C urnu <br />nauou <br />}'' <br />yp?y <br />f / <br /> <br /> <br /> <br />1. Sample Type: Air Water <br />2. Analysis - Test series requested: f <br />3. 1 <br />4. <br />S. <br />N: P.O. Box 700 <br />Nucla, CO 81424 <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />rG fir #f. vrr'n. <br />r, <br />Soil Other (specify): <br />Late analysis required by (if not Holding 'rune): <br />Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial <br />COMMENTS - Explanation of noted items: <br />) and explain below. A:. <br />( ) Check if additional attachments, <br />QA Review: <br />. Sample valid? YES ( ) NO <br />01- <br />) If NO, explain: <br />QAC <br />Date <br />-Page 32 of 36 <br />i