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__UIIcr l <br />l 1 <br />C : P.O. Box 1750 ' "S: P.O. Box � I750 <br />Cation City, CO 81215 Cafou City, CO 81215 <br />Sample LoeJ J <br />ID No. _ �' ' €.t� .: Lab. No.(s) <br />2 .. 0 4 <br />Sample '5 -x" Time 9 • / 's r Date Data Entere <br />Collected y o ► r+‘ w/ c.;,,- <br />4 <br />Field Custodian 1 P r d 4. t <br />Delivered By <br />Received By <br />Date Recd. <br />OY YO�L'iiiu yLMLi:�iY...i.SS.La <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal <br />O[ au... t4 <br />• Field; Data - Preservation: r [ <br />7A- e.: , rya! 2 :A.. 3 <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) it NO, explain: <br />QAC <br />} e:Kw.i .;.∎ 4 .- : . ' J.J. -Y <br />N: Box 700 <br />Nudla, CO 81424 <br />la Entry By <br />Laboratory Desti ation if not Cotter: <br />` :„., tyI '4 Ale t' " <br />3 3 S ./ - ere E' <br />(7,2 .%)--3Not S. Z z <br />Time Recd. <br />e. Air Water Soil ' Other (specify): <br />1. Sat1t�e•'T9P � t ). m y <br />2 naI sis - Test series requested: le <br />6. Invalidating: circumstances? If YES initial ( ) and a plain below. <br />COMMENTS - Explanation of noted items: <br />/1 14,,,122-tews 611 <br />4 , r. <br />• Date analysis required by (if not Holding Time): < ;. <br />• Special handling conditions or other instructions: <<, <br />