Laserfiche WebLink
L,rVLLCC <br />- to <br />e8 ma VL <br />, <br />1 <br />tia. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND. TRACKING FORM �:� s2 :5*66 <br />'' <br />Sample Submittal : <br />C: P.O. Box 1750 S: P.O. Box 1750 <br />Cation City, CO 81215 Canon City, CO 81215 <br />Sample Loc./ID No. 0 S Lab. No.(s) <br />Sample Date 7` 19 O/l Time � , � L , ? t- Date Data Entered <br />Collected By el 4 if ° -' ti +s . / Data Entry By <br />Field Custodian <br />Delivered By <br />Received By <br />Date Recd. <br />Off Si D t ti <br />Laboratory Destination if not Cotter: <br />0 e ? - 2 2 J <br />Time Recd. <br />tr:- <br />1. Sample Type: Air Water f� p Soil Other (specify): <br />2. Analysis - Test series requested: , <: A , 0 <br />3. Field Data - Preservation: 7 /( isf - 7. 7 V re .. • Z. O <br />f" < . ^t , ; a 3 fl 4, - `y - / /14/{)- L;" <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 />N: P.O. Box 700 <br />Nucla, CO 81424 <br />Page 36of38 <br />9 � <br />