Laserfiche WebLink
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />- <br />Sample Submittal 110 S11436-, <br />C: P.O. Box 1750 S: P.O. Box 1750 <br />Cation City, C0 81215 Cason City, CO 81215 <br />Sample LecJID No. Lab. No.(s) _ <br />Sample Date .2 dalime Date Data Entered <br />Collected By 904 7 =- Data Entry By <br />Field, Custodian n ^ ?p.?r•' E .4 Laboratory Destination if not Cotter: <br />OB-S'te D tination <br />Delivered By <br />Received by <br />Date Recd. <br />Time Recd. <br />1. <br />2. <br />3. <br />4. <br />5. <br />Cotter 1 <br /> <br /> <br />- { 446 <br /> <br />Sample Type: Air Water <br />Analysis- Test series requested: <br />Z 3 93 S <br />Soil Other (specify): <br />Field Data - Preservation: T /7 Q _ `-V <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 Date <br />I <br />?. _ .... ---- -- ---Page -39 ??3&... _ -- -- ----- - - <br />N: P.O. Box 700 <br />Nucla, CO 81424 <br />Date analysis required by (if not Holding Time): <br />Special handling conditions or other instructions: