Laserfiche WebLink
COTTER CORPORATION SAMPLE SUBMITTAL AND: TRACKING FORM <br />Sample Submittal 525487 <br />C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Caiion City, CO 81215 Nucla, CO 81424 <br />Sample Loc./ID No. <br />Sample Date Time <br />Collected By <br />Field Custodian /Z Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />LU[I.Cr vi.-a?ac ucauua?,vu <br /> <br /> JI)D <br /> <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destiiation if not Cotter: <br /> <br />C1 ~• <br />1. Sample Type: Air Water ? Soil Other (specify): <br />2. Analysis - Test series requested: <br />i <br />3. Field Data - Preservation: <br />r <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: <br />QAC Date <br />Page 6 of 6 <br />