2011-04-08_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 4/8/2011
• Doc Name: Mar. 2011 SW Data- Pt.1
• 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 _ S8
C: P.O. Box 1750 S: P.O. Box 1750
Canon City, CO 81215 Canon City, CO 81215
Sample Loc./ID No:
Lab. No.(s)
N: P.O. Box 700
Nucla, CO.81424
Sample Date Time .3 S Date Data Entered
Collected By aZ f _ti.•v.? Data Entry By
Field Custodian Mi 6>c+ .,I r Laboratory Destination if not Cotter:
D Z
Delivered By.
Received By
Date Recd.
Time Recd.
otter
C Off-Site estiaation
y-qC

11? 1. Sample. Type: Air Waters / Soil Other (specify):

2. Analysis - Test series requested:
3. Field Data - Preservation:
4... Date analysis required by (if not Holding Time):
5: Special handling conditions or other instructions:
& Invalidating circumstances? If YES initial ( ) and explain below. :.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date