2011-06-20_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/20/2011
• Doc Name: May 2011 SW Quality Data- SW 5/10/11 S25777-S25784.
• From: ENERGY Labs and Cotter Corp.
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

Company Name: Cotter Corporation
Tracking No. 3692013 61578355
Project Name: Schwartz - Ill
DATE: _5110111 SSTF: S25777--S25784
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81215 -
Contact Name: Randy Whisker
719- 275 -7413 ext. 210
Sampler Name if other than Contact:
1- 303 -642 -3893 mine phone
Bob Tennant 1- 719- 371 - 3009 -cell
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
JoAnne Ary
413 ext. 209
Fax: 1669
Purchase Order #:
ELI Quote #:
Report Required For: POTWI
Other
g Number of Contains
D Sample Type:
—I AWSVBO
Xl Air, Water Soils/Solids, Vegetation,
X Bioassay Other
Normal Tumaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
P additional charges
t and scheduling
Rec. t p
—t , C
U - dissolved only - CODE #1
£# 300D - P - n
Ra-226 total & dissolved CODE#3
SEE ATTACHED TABLE 1
q�er D_(s) ,�
CoM l
Special Report Formats — ELI must be
prior to sample submittal for the following:
NELAC ❑ A2LA ■ Level
Other
EDD /EDT ❑ Format
Custody eai
Y !
Intact VVV
Y / N
Signature
Y / N
Match LAB ID
Y / N
RUSH Turnaround
Comments:
S&A Schedule Code :
SW CODE I 1
Table 1
Frequent 1
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
wo coolers
1 SW AWD
5/10/11
10:15
Water
•
❑
❑
0
•
•
•
❑
❑
❑
0
•
Table 1
2 SW A001
5110111
10:35
Water
®
•
•
•
•
•
•
❑
❑
•
®
❑
Code 1
3 SW BDIS
5/10/11
11:55
Water
o
•
❑
❑
❑
❑
❑
❑
❑
•
El
•
Code 1
° SW PL
5/10/11
12:05
Water
®
•
❑
❑
❑
❑
❑
•
❑
•
El
❑
Code 1
5 SW OS
5/10/11
13:30
Water
o
•
•
❑
❑
❑
❑
❑
❑
•
®
0
Code 1
8 SW BOS '
5/10/11
13:35
Water
®
•
❑
•
•
•
❑
❑
•
•
El
•
Code 1
SW GS
5/10/11
14:45
Water
®
❑
•
❑
•
•
❑
•
❑
•
El
•
Code 1
8 SW BPL
5/10/11
14:55
Water
•
.
❑
•
•
.
®
❑
•
.
•
.
❑
❑
•
•
❑
❑
•
•
El
❑
0
Table 1
9
/S"6/2>?
10
•
❑
❑
•
❑
•
❑
•
•
•
❑
❑
11
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:5 /11/11 11 30
Shipped by: cepifx _
Shipped by:
Received by : Daterrime :s / g
Relinquished by: Date/Time:
Received by: Date/Time:
Sample Disposal: Retum to Client • Lab Disposal 0
LABORATORY USE ONLY
Sample Type # of fractions
Chain of Custody and Analytical Request Record
PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1
PV lo GE abed