2011-07-28_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 7/28/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 6-10-11.
• 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 61578492
Project Name: Schwartz -
DATE: _6/10/11 SSTF: S25837
Report Mall 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
is 1- 719 - 275 -7413 ext. 209
t: 1 719 - 275 - 1669
Purchase Order #:
ELI Quote #:
Report Required For: Pormarrp 0
Other
Number of Containers
Sample Type:
AWSVBO
Air, Water Soils/Solids, Vegetation,
�C Bioassay Ober
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
A and scheduling
Receipt Temp
/'-(. L ° C
TABLE 2 - Footnote "2" applies
TABLE 2 - Footnote "1" applies
Cooler ID(s) h
(74". M.
Special Report Formats — ELI must be notified
prior to sample submittal for the following:
NELAC ❑ A2LA • 1
Other
EDD /EDT ❑ Format
RUSH Turnaround (T
Comments:
SBA Schedule Code :
GW CODE:
Fre ue
Custody al
Y N �
Intact
Y / N
Signature
Y / N
Match LAB ID
Y / N
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
SUMP - -1
6/10/11
10:40
Water
-o
❑
❑
•
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•
•
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®
Table 2
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Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:6 /10/11 14 30
Shipped by:
Received by ' y / Date/Time _
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
riiNif Chain of Custody and Analytical Request Record
wrizzarmy
PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1