2011-07-22_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 7/22/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 6-23-11.
• 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 61578553
Project Name: Schwartz -
DATE: _6123/11 SSTF: S2585O
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81215 -1750
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
: 1- 719 - 275 -7413 ext. 209
t: 1 719 275 - 1669
Purchase Order #:
ELI Quote #:
Report Required
Special Report
prior to sample
NELAC •
For: POTWNW
Other
TP
notifies
IV •
1
o 1
m
y
3
a
��
MATRIX
Normal Turnaround (TAT)
a
RUSH Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
and scheduling
Rec9ipl TAmp
(A - '1---2C
solldde .a" 9 - z 31e
TABLE 2 - Footnote "1" applies
Formats —
submittal for
A2LA •
ELI must be
the following:
Level
C er ID(s)
Comments:
SBA Schedule Code :
OW CODE:
Fre ue
Custody Cl
I
Y
Intact
Y / N
Signature
Y / N
Match LAB ID
Y / N
Other
EDD /EDT 0 Format
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
1 MW - 6
6/23/11
10:00
Water
•
Table 2
•
•
•
•
•
•
•
•
•
❑
❑
D
❑
❑
❑
❑
•
•
•
■
•
D
❑
D
0
•
•
•
•
•
•
■
•
❑
❑
❑
0
•
•
•
.
.
.
.
■
5
0
0
0
0
0
D
❑
ii069100,-
•
•
•
•
•
s
0.
D
❑
❑
0
■
■
■
■
■
■
0.
D
❑
❑
D
❑
■
■
■
■
■
s
❑
❑
❑
•
■
■
■
■
■
■
■
■
9
❑
❑
■
■
■
■
■
■
■
■
■
■
10
0
0
0
•
•
•
•
•
•
•
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant
Date/Time:6
/23/11
13 30
Shipped
by:
Received
by: L Date/Time:
_
6.9' j ( 9
Relinquished by: Date/Time:
Shipped by:
Received by: ) Date/Time:
Sample Disposal: Return
Lab Disposal ®
LABORATORY USE ONLY
Sample Type # of fractions
to Client
•
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