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

C: P.O. Box 1750
Cation City, CO 81215
Sample Loc./ID No.
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal ..2 s 25779
Sample Date ' - / -2o11 Time /1 ! � 5 -
Collected By go f, 7 ','e -t
Field Custodian r'3n 6 ��' �"' VC
C tie Off Si Destination '...-1 P.
Delivered By ?-3 /
/ " Gs! e . - > #, .0 a k 17-, --
,�
Received By ` ' y ' P � i) l / G ;'1 ,... 2
Date Recd.
Time Recd.
(
1. Sample Type: Air Water / Soil Other (specify):
2. Analysis - Test series requested: (9 •- r4 1
3. Field Data - Preservation: Q /0. /1.
t / O,6 '
S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Nucla, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
1)ll 7, 94( ( A.): 2 fi U u S ‘
.y 1 /� /x.0 2 .
4. Date analysis required by (if not Bolding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial ( ) and explain below.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date
Page 39 of 44
A -
/)
• .f
.
C: P.O. Box 1750
Cation City, CO 81215
Sample Loc./ID No.
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal ..2 s 25779
Sample Date ' - / -2o11 Time /1 ! � 5 -
Collected By go f, 7 ','e -t
Field Custodian r'3n 6 ��' �"' VC
C tie Off Si Destination '...-1 P.
Delivered By ?-3 /
/ " Gs! e . - > #, .0 a k 17-, --
,�
Received By ` ' y ' P � i) l / G ;'1 ,... 2
Date Recd.
Time Recd.
(
1. Sample Type: Air Water / Soil Other (specify):
2. Analysis - Test series requested: (9 •- r4 1
3. Field Data - Preservation: Q /0. /1.
t / O,6 '
S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Nucla, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
1)ll 7, 94( ( A.): 2 fi U u S ‘
.y 1 /� /x.0 2 .
4. Date analysis required by (if not Bolding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial ( ) and explain below.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date
Page 39 of 44