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COTTER CORPORATION SAMPLE SUBMITTAL AND. TRACKING FORM <br />Sample Submittal ? " S 2!-543 <br />C: P.O. Box 17SO S: P.O. Box 1750 N: P.O. Box 700 <br />Cafion City, CO 8121S Cafion City, CO 8121S Nucla, CO 81424 <br />Sample LocJID No. <br />Lab. No.(s) <br />Sample Date Timed' Date Data Entered <br />Collected By ~ max. .... ?v . Data Entry By <br />Field Custodian Laboratory Destination if not Cotter: <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />a.v?aca uvuo yceuuauuu <br />?-. AM" <br /> <br /> <br />1. Sample Types Air Water <br />2. Analysis - Test series requested: <br />Other (specify): <br />3. Field Data - Preservation: ? <br />- <br />f/tf •? ..' .?_ -'` ?'. <br />? ? r( .. t i" ?a f/ ? <br />1 ?F „"'l r V 1'7' l' ? r T <br />.t- <br />4. Date analysis required by (if not Holding Time): _ <br />S. Special handling'conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. . <br />COMMENTS - Explanation of noted items: <br />~r r <br />Soil <br />-~ rx <br />