2011-05-11_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 5/11/2011
• Doc Name: March 2011 SW Data- 3-29-11
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal rLe S 2516 6 5
C: P.O. Box 1750 S: P.O. Box 1150. N: P.O. Box 700
Cason City, CO 81215 Cagan City, CO 81215 Nucla, CO 81424
Sample LocJID No. S 4.113
Lab. No.(s)
r
Sample Date '. y?f Time _ ?? S"S
Collected By d iD.vAl CA.,e
Field Custodian ?.??
Date Dicta Entered
Data Entry By
Laboratory Destination if not Cotter:
?..:?e.t L/ Z-a/- 4 Or a 0e eIS
Delivered By 7 3 9.3 it SGA'r i! L. ?4/
Received By 1
Date Recd.
Time Recd. C16 L r ov
1. Sample-Type: Air Water l Soil Other (specify):
2. Analysis - Test series requested: (0,
3. Field Data - Preservation: 7- 7 7 2 77'
4. Date analysis required by (if not Holding Time):
S.- Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial ( ) and explain below.
COMMENTS. - Explanation of noted items:
( ) Check N additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) 'If NO, explain:
Date