Laserfiche WebLink
L..VLLCI" <br />pti umauu uvu <br />. Mc <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 />2.2 <br />Sample Submittal <br />C: P.O. Box 1750 <br />Cation City, CO 81215 <br />Sample Date 7- 12- "line // S <br />Collected By �..? 4 <br />Field Custodian Lev /a " .# r• -. <br />1. Sample Type: Air Water <br />( 4::'$../4. Soil <br />2. Analysis - Test series requested: / <br />3. Field Data - Preservation: 7 1 . f `✓ <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Cation City, CO 81215 Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />23`x. . /t r eoe ., • <br />/. 7661_ <br />QAC Date <br />Other (specify): <br />r.� ... 2 ... -.. 5e. <br />_ $ <br />9 S g <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 ( J )) and explain �below. y <br />COMMENTS - Explanation of noted items: �"'r �.� t . -- /,[{/ f <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />