2011-07-07_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 7/7/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 6-2-11.
• 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 61578461
Project Name: Schwartz -
DATE: 6/2/11 SSTF: S25801
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
"'e1: 1- 719 - 275 -7413 ext. 209
Fax: [phone] - 1669
Purchase Order #:
ELI Quote #:
Report Required
Special Report
prior to sample
NELAC ❑
Other
For: POTW/WWTP
Other
notified
IV •
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a
CO
y
L r B
E a 48 i
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MATRIX
F
a
t
Normal Turnaround (TAT)
c.
a
RUSH Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
and scheduling
Re i t T mp
.' °C
a
TABLE 2 - Footnote "2" applies
a
TABLE 2 - Footnote "1" applies
Formats —
submittal for
A2LA •
ELI must be
the following:
Level
Ier ID(s)
�� i
Comments:
S&A Schedule Code :
GW CODE:
Fre uen
Custody eat
Y j
Intact
Y / N
Signature
Y / N
Match LAB ID
YIN
Format
EDD /EDT •
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
SUMP - -5
6/2/11
8:55 -
Water
®
❑
❑
❑
®
❑
Table 2
•
•
•
•
.
1
s
❑
❑
❑
❑
•
•
•
.
■
.
■
.
❑
❑
❑
❑
■
.
■
.
■
■
.
.
0
0
0
0
0
0
❑
•
0
•
•
•
0
0
0
0
0
0
0
0
0
•
•
0
e
❑
❑
❑
❑
❑
❑
❑
•
•
.
.
■
❑
0
0
El
7 •
•
•
■
.
•
.
.
J
8
4
❑
❑
❑
❑
❑
❑
❑
•
•
•
•
•
10
0
0
0
0
❑
❑
•
•
.
•
•
•
Custody
Record
MUST be
Signed
Relinquished
by: Bob Tennant Date/Time:6
/2/11
14:30
Shipped
by:
Received
by: ate/Time:
'
Relinquished by: Date/Time:
Shipped by:
Received by: `) Date/Time:
Sample Disposal: Return
Lab Disposal
LABORATORY USE ONLY
Sample Type # of fractions
to Client
•
e
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
j, 40 9 aBed