2011-07-11_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 7/11/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 5-26-11.
• 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 61578430
Project Name: Schwartz -
DATE: 5126/11 SSTF: S25771
T
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81;
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
Invoice Address:
PO Box 1750
Canon City, CO 81215 - 1750
Invoice Contact: JoAnne Ary
: 1- 719 - 275 -7413 ext. 209
:: 1 719 - 275 - 1669
Purchase Order #:
ELI Quote #:
Report Required For: PC
Other
K Number of Containers
y Sample Type:
—I AWSVBO
W Air, Water SoilsISolids, Yegetabon,
X Bioassay gther
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
a and scheduling
R ipt T
c
amide nZ.. caoinooa - Z 31841
sal,dde ..L,. 04O - t 31941
Special Report
prior to sample
NELAC •
Other
EDD /EDT •
Formats — ELI must be notified
submittal for the following:
A2LA ❑ L
Format
C Ier ID(s)
RUSH Turnaround (T
Comments:
S&A Schedule Code :
GWCODE:
Fr ue
Custody S aI
Y ,t,pl')
Intact
Y/N
Signature
Y / N
Ma LAB ID
YIN
SAMPLE
IDEOi1PICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
SUMP - -8
5/26/11
11:30
Water
®
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Table 2
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9
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&AS-6
10
(
•••••❑•••❑
❑❑
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant DatelTime:5/26 /11 16 30
Shipped by: Ale
Shipped by:
Receiv Al' te/Time: Y.:97 /l /�
Relinquished by: Date/Time:
Received by: Date/Time:
Sample Disposal: Return to Client • Lab Disposal 0
LABORATORY USE ONLY
_ Sample Type # of fractions
SHIM
U16C�RATOR/ES 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