2011-03-03_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 3/3/2011
• Doc Name: Jan. 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 I NI s 2S4,43
C: P.O. Box 1750 S: P.O. Box 1750
Canon City, CO 81215 / Caiion City, CO 81215
Sample LocJID No. !? I / Lab. No.(s)
Sample Date Time
Collected By /Io 7-,o--' .
Field Custodlan
Delivered By
Received B
Date Recd.
Time Recd.
?.u?acr vaa-?iac irc?uuauvu
s

Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:

,r

r ?.
1. Sample Type: Air Water _ Soil Other (specify):
^
2. Analysis - Test series requested: fn r
3. Field Data - Preservation: A/ 14, F
• f
4.
S.
Date analysis required by (if not Holding Time): -
Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO( ) If NO, explain:
QAC
) and explain below.
Date
N: P.O. Box 700
Nucla, CO 81424
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