Laserfiche WebLink
Delivered By <br />Received By <br />Date Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal : 2 s ZS $6 3 <br />C: P.O. Box 1750 <br />Cafion City, CO 81215 <br />Sample Loc./ID No. C 4 1 1! Dr C Lab. No.(s) <br />Sample Date 7- / 9. 20 / 'rime if A : Date Data Entered <br />Collected By 6 4 <br />Field Custodian 4 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />t <br />Z ? 5 <br />/t r bf <br />e.; r. •/ <br />Time Recd. 1 i • <br />1. Sample Type: Air Water f Soil Other (specify): <br />2. Analysis - Test series requested: (: ci + <br />3. <br />Field Data - Preservation: 1 if, 2 <br />- 7. <br />• 9s- ,„ 1 G. <br />A r <br />A ...3 • <br />'1.i I:: el 3.34 14 ,C //IV 6,/ <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: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC Date <br />Page 33 of 38 <br />%-.LPIGICK <br />L111 arcossuguun <br />P...,..7 Z <br />. <br />. :1 , <br />W 4. , <br />, <br />''..) <br />Delivered By <br />Received By <br />Date Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal : 2 s ZS $6 3 <br />C: P.O. Box 1750 <br />Cafion City, CO 81215 <br />Sample Loc./ID No. C 4 1 1! Dr C Lab. No.(s) <br />Sample Date 7- / 9. 20 / 'rime if A : Date Data Entered <br />Collected By 6 4 <br />Field Custodian 4 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />t <br />Z ? 5 <br />/t r bf <br />e.; r. •/ <br />Time Recd. 1 i • <br />1. Sample Type: Air Water f Soil Other (specify): <br />2. Analysis - Test series requested: (: ci + <br />3. <br />Field Data - Preservation: 1 if, 2 <br />- 7. <br />• 9s- ,„ 1 G. <br />A r <br />A ...3 • <br />'1.i I:: el 3.34 14 ,C //IV 6,/ <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: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC Date <br />Page 33 of 38 <br />