Laserfiche WebLink
C: P.O. Box 1750 S: <br />Canon City, CO 81215 <br />Sample Loc./ID No. 5' W ©'.5 <br />Sample Date 6 72°/f - Time P.70 <br />Collected By d I p -• e t <br />Field Custodian 415.41 <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal 115.• s 25*30 <br />Cotter <br />Delivered By Ash 7p..r •vi-t <br />Received By CPci <br />Date Recd. �i/Y <br />Tillie Recd. /if --c <br />1. Sample Type: Air <br />2. <br />Of Site Destination <br />O.0/ <br />/ <br />t'. , &dam /t om f� , # <br />QAC <br />P.O. BOX 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nacla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />} <br />Z 393 s6Jf e 4 Hc.✓ y. <br />, FS1602 <br />Water f Soil Other (specify): <br />Analysis Test series requested: ( i <br />3: Field Data - Preservation: / 4 f / p4 f d ] <br />. � , • $ r7 / 7 / � 9 C ti' el. �2 �' g ef 2 ) air <br />J w <br />I''Via/ S C O 1 / I . [ ( ! `` j V. S 7 tf l! J- 3 Ir+ t <br />'mow. .s-a <br />4. Date analysis required by (if not Holding Time): <br />S. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( )) explain below. <br />�t".1 <br />COMMENTS - Explanation of noted items: /le-- l u r "�- t! life <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />Date <br />Page 37 of 41 <br />