Laserfiche WebLink
a.ULI <br />U <br />- 1 C eS lna WHIMS <br />:N., <br />ti 0 <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal !:2 S 2 5 8 5 4 <br />C: P.O. Box 1750 <br />Canon City, CO 81215 <br />Sample Loc./ID No. ,�' 4 Qd t Lab. No.(s) <br />Sample Date '7- (n 2 v// Time // :9 0 <br />Collected By Al 6 <br />Field Custodian I. Q 4. rP.rvNG -4 7 <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />oft S • t D r <br />O. 98 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />Date Data Entered - <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />- , �, 1 , r s T,,. c <br />73q3 S4Jt 4 # wy. <br />Cc. 5 7�,i ((iy. ?zt or <br />Ne <br />1. Sample Type: Air Water f Soil Other (specify): <br />2. Analysis - Test series requested: ( i1 t / <br />df ( f 3. Field Data - Preservation: �6 � f 7. C ,c � /� 5 A- • z !t 5 <br />® s LIA / / 2 . 5 <br />■ <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS - Explanation of noted items: (f rfv - C i i ‘c ! 7 . <br />r L. <br />411' I <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC Date <br />P209 37 of /13 <br />