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 N10 S25643
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Cafion City, CO 81215 Cafioa City, CO 81215 Nucla, CO 81424
Sample Loc./ID No. W /C7 2f4
Sample Date .2 2. mine 13 o?• 6
Collected By .r
Field Custodian T.9w??
Delivered B5
Received By
Date Recd.
Time Recd.
l.V «Ci- v11-011 Lc3uiiuVu

Lab. No.(s) _
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
ivE'.i?tr ze-zor4c ovlr.s. ?C.

1 & `#1j E+/
1. Sample Type: Air Water 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:
.6. Invalidating circumstances? If YES initial ( } and explain below.
COMMENTS - Explanation of noted items:
{ ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) . NO( ) It NO, explain:
QAC
Date
i