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1....OTICE <br />g O 4 7;../..sc..... 1 <br />red' Ey <br />fed 4-,.... <br />4.acsoirro.n <br />taut) <br />- i <br />,Tkect C-7 <br />Sample No. C) 4 6dr) <br />Sample Date - — Ill rune <br />• Collected By g0 4. 1116,1" ."1 • <br />• Field Custodian got <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />1. <br />2. <br />3. Field Data — Preservation: r- p#7.) , ‘ , e../ 2 4 5 10 a.'e7 s <br />,(1. 1.7s e at- s-c- -e2.-r.:-44-'IE7 <br />54? - /144 1 e FA#A./ © 2 S Z ■4 Z ga4 <br />1- I. ziA/Y ...cO 5 ..-4 0, 5 I- 4I/4/tA a,* 2. <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS — Explanation of noted items: <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />C: P.O. Box 1750 S: <br />Cafion City, CO 81215 <br />) Check if additional attachments. <br />QAC <br />Sample Submittal <br />112 s25692 <br />P.O. Box 1750 N: • P.O. Box 700 <br />Calton City, CO 81215 Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />L c c . <br />z 91 #,,, y <br />kJ F 26 0 <br />Sample Type: Air Water Soil Other (specify): <br />Analysis — Test series requested: ra ie <br />• QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />Date <br />