2011-08-01_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 8/1/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 6-29-11.
• 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 61578577
Project Name: Schwartz - •
DATE: 6/29/11 SSTF: _25824
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81
Contact Name: Randy Whicker
Voice: 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
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
Invoice Contact: JoAnne Ary
l: 1 719 - 275 - 7413 ext. 209
K: 1 719 275 - 1669
Purchase Order #:
ELI Quote #:
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
c and scheduling
Rec j t. mp
o C
Report Required For: PC
Other
TABLE 2 - Footnote "2" applies
TABLE 2 - Footnote "1" applies
Special Report Formats — ELI must be notified
prior to sample submittal for the ft
NELAC ❑ A2LA ❑ Level IV
Other
EDD /EDT ❑ Format
5 Number of Containei
Sample Type:
AWSVBO
Air, (Mater Soils/Solids, Vege
X Bioassay Other
C
RUSH Turnaround (T
Comments:
S&A Schedule Code :
GW CODE:
Fr uenc :
Custody al
Y
Intact
Y / N
Signature
Y / N
Match LAB ID
Y/N
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
M - 7
6/29/11
14:25
Water
®
•
❑
❑
■
❑
❑
❑
❑
❑
0
•
Table 2
2
❑
❑
•
❑
•
•
❑ ❑
❑
❑
•
❑
❑
❑
❑
❑
•
❑
❑ •
❑
❑
•
•
4
•
❑
❑
❑
•
❑
■ ❑
❑
❑
•
■
5
❑
❑
❑
•
❑
•
• ❑
❑
❑
❑
0
6
•
❑
•
•
❑
•
❑ ❑
❑
❑
•
❑
❑
❑
❑
❑
•
❑
❑ ❑
❑
❑
❑
•
e
0
•
0
•
0
•
0 0
0
•
0
0
•
❑
❑
■
❑
❑
•
❑ •
❑
❑
❑
•
/ / / / / / {�, /j�
(f 7W �/
10
❑
•
❑
•
❑
• ❑ ❑ • ❑
•
■
t '
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:6 /30/11 16 30
Shipped by: /ed-Le
Shipped by:
Rece • • • )10,4 �'i f i p
Received by: Date/Time:
Relinquished by: Date/Time:
Sample Disposal: Return to Client ❑ Lab Disposal 0
LABORATORY USE ONLY
Sample Type # of fractions
MEM 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
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