Laserfiche WebLink
<br /> <br />COTTER CORPORATION SAMPLE SUBMITTAL AND. TRACKING FORM <br />Sample Submittal ig_ S is 0 <br />Sample LocJID No. Lab. No.(s). <br />Sample Date 'eX 7"2t?t1 Time J 3 y0 Date Data Entered <br />Collected By (0 Data Entry By <br />Field Custodian a Labotatory Destination if not Cotter: <br />Cotter Off-Site Destination i 414 zodr r, &V C .00 /6 <br />Delivered By ,p Q <br />Received By - I OK 9z 6 Q Z <br />W or <br />Date Recd. Aam <br />Time Recd. <br />1. Sample Type: Air Water Soil Other (specify): <br />d?? f <br />2. Analysis - Test series requested: <br />C: P.O. Box 1750 S: P.Q. Box 1750 N: P.O. Bolt 700 <br />Cafion City, CO 81215 Cafion City, CO 81215 Nucla, CO 81424 <br />3. Field Data - Preservation: <br />r ? rv <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: