2011-06-24_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/24/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 5-19-11.
• 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 61578409
Project Name: Schwarz -
DATE: _5/19/11 SSTF: 525338
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
: 1- 719 -275 -7413 ext. 209
c: 1 719 - 275 - 1669
Purchase Order #:
ELI Quote #:
Report Required For: POTWNVVVTP
Other
Number of Containers
Sample Type:
� -I AWSVBO
Air, Water Soils/Solids, Vegetation,
X Bioassay Other
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
additional charges
a and scheduling
Receipt Temp
2% (o ° C
TABLE 2 - Footnote "2" applies
TABLE 2 - Footnote "1" applies
Cooler ID(s)
C. r r 'e Kt
Special Report Formats — ELI must be notified
prior to sample submittal for the following:
NELAC ❑ A2LA • Level IV El
Other
EDD /EDT Format
RUSH Turnaround (T
Comments:
SSA Schedule Code :
GW CODE:
Fre ue
Custody al
intact
to
Y/
Signature
Y ! N
Match LAB ID
Y / N
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
MW -3 A
5/19/11
8:40
Water
®
•
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Table 2
2
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0
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0
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0
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0
0
0
0 1
0
0
0
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0
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0
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e
0
0
0
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8
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0
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0 0
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Custody
Recorde
MUS
Signed
Relinquished by: Bob Tennant Date/Time:5 /19111 14 30
Shipped by:
Received by ` 0 ate/Ti me: = -
Relinquished by: Date/Time:
Shipped by:
Received by: • Date/Time:
Sample Disposal: Return to Client • Lab Disposal @
LABORATORY USE ONLY
Sample Type # of fractions
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