2011-06-01_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/1/2011
• Doc Name: June 2011 SW Data
• From: Energy Labs
• To: Cotter and DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

Company Name: Cotter Corporation
Tracking No. 3692013 61578447
Project Name: Schwartz - 1
DATE: SSTF: S25340-- S25347
_ 6/01111
Contact Name: Randy Whicker
1- 719 -275 -7413 ext, 210
Sampler Name if other than Contact:
1- 303 -642 -3893 mine phone
Bob Tennant 1- 719 -371- 3009 -cell
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
Invoice Contact: JoAnne Ary
75 -7413 ext, 209
Fax: 275 - 1669
Purchase Order #:
ELI Quote #:
Report Required For: PC
Other
Number of Contains
Sample T
AWSVBO
Air, water Soils/Solids, yegetabon,
X Bioassay ether
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
p additional charges
t and scheduling
Recei t Temp
p C
U - dissolved only - CODE #1
C# 3000 - PaMIP'811 n
Ra-226 total & dissolved CODE#3
SEE ATTACHED TABLE 1
C le l- _
Special Report
prior to sample
NELAC •
Other
EDD /EDT •
Formats — ELI must be notified
submittal for the following:
A2LA • 1
Format
Custody eal
Y
Intact
Y
Signat
Y /
Match LAB ID
Y / N
punoueuun2. HSnM
Comments:
SBA Schedule Code :
SW CODE I 1
Table 1
Frequency 1,
Two coolers
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
lime
1 SW AWD
5/31/11
8:35
Water
®
•
•
•
❑
❑
❑
❑
❑
❑
►-
•
Code 1
2 SW AOO1
5/31/11
8 :45
Water
®
•
❑
•
•
•
•
•
•
❑
®
•
Code 1
3 SW BDIS
5/31/11
8:55
Water
®
❑
•
❑
❑
❑
❑
❑
•
❑
0
❑
Code 1
° SW PL
5/31/11
9:50
Water
❑
■
■
c
❑
■
■
❑
■
❑
0
•
Table 1
B SW OS
5/31/11
10:10
Water
®
■
•
❑
❑
❑
❑
❑
■
■
0
■
Code 1
6 SW 80
6/01/11
9:45
Water
0
❑
■
■
■
❑
❑
■
❑
❑
=4
•
Code 1
7 SW GS
6/01/11
9:55
Water
0
■
■
❑
■
❑
■
❑
■
❑
0
❑
Code 1
9 SW BPL
6101/11
10:05
Water
0
•
•
❑
•
❑
•
❑
•
0
0
•
Code 1
r Rdso//-
9
CI
❑
•
❑
•
❑
❑
•
•
•
I •
❑
10
■
■
■
❑
■
■
■
❑
■
❑
❑
■
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:6 /01/11 14:30
Shipped by: ' -e6, fy
Received b . Date/Time: ' / /a
Relinquished by: Date/Time:
Shipped by:
Received by: Date/Time:
Sample Disposal: Return 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