Laserfiche WebLink
ILMI.IXF <br />1.111 .I.Miltimataws <br />IA , e .. ........,.„ <br />— w <br />Sample Loc./ID No. <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal S 15277 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />C: P.O. Box 1750 <br />Canon City, CO 81215 <br />• Sample Date 1 40 Time ) S <br />Collected By <br />• Field Custodian , <br />l. Sample Type: Air Water Soil Other (specify): <br />2. Analysis - Test series requested: <br />.3. Field Data - Preservation: rt 3 3 ec e" <br />r <br />I 0,0 <br />QAC <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />Z . <br />) • - fr- <br />ear — <br />( ' l'A„/ / <br />O s L fr A „1,4 <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 />.rne <br />COMMENTS - Explanation of noted items: te.# LJ 4 61* ki 1 (.ga frze ) <br />f <br />/A , 4 4 '0- e24.-• fi 7'; <br />) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />Date <br />