2011-05-17_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 5/17/2011
• Doc Name: 2nd Qtr. 2011 GW Monitoring Data- 4-15-11.
• From: Energy Labs
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

Company Name: Cotter Corporation
Tracking No. _3692013 61576030
Project Name: Schwartz -
DATE: _4115111 SSTF: S25714
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
Fax: [phone] - 1669
Purchase Order #:
ELI Quote #:
Report Required For: POT
Other
K Number of Containers
D Sam Type:
-I AWSVBO
Air. Water Boiis/Solids, Vegetation,
X Bioassay Other
Normal Turnaround (TAT)
Notify ELI prior to z7 ,
RUSH sample
submittal for
additional charges
a and scheduling
Recei t T
1..1-`4 o C
Cooler ID(s)
Ui h0ihC,
[TABLE 2 - Footnote "2" applies 1
t
selldde..L„ 3 1 04 400J -Z 318V1
Special Report Formats - ELI must be notified
prior to sample submittal for the folly
NELAC 0 A2LA • Level IV
Other
EDD /EDT 0 Format
RUSH Turnaround (7
Comments:
S&A Schedule Code :
GW CODE:
Froe
Custody Seal
Y /6.',.
Intact
Y / N
Signature
Y / N
Match LAB ID
Y / N
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
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4/15/11
10:00
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Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:4 /15/11 13 30
Shipped by:
Received .y: Datefrime:
Relinquished by: Date/Time:
Shipped •
id ' Date/Time: / -'
Sample Disposal: Return to Client 0 Lab Disposal ®
LABORATORY USE ONL
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
61. Jo Lt. abed