2011-09-12_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 9/12/2011
• Doc Name: SWQ Monitoring- July 2011- Part 2
• From: Cotter
• To: CDPHE-WQCD and DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal * t :2 s 25867 •
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Canon City, CO 81215 Nncla, CO 81424
Sample Loc./ID No. C Li C C Lab. No.(s)
Sample Date 5 .2 / Time I I / S. a Date Data Entered
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Field Custodian d il 1 , 4 • ' r - , p, ,g,e 6 st, t Laboratory Destination if not Cotter:
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Date Recd.
Time Recd.
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1. Sample Type: Air Water Soli Other (specify):
2. Analysis - Test series requested: , e
3. Field Data - Preservation: T 4" /4 g 13, .1,2L/ 6, 5
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4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
) and explain below.
COMMENTS - Explanation of noted items:
) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date
Page 37 of 38
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r. !..
I 16 0 i
Date Recd.
Time Recd.
Ate
1. Sample Type: Air Water Soli Other (specify):
2. Analysis - Test series requested: , e
3. Field Data - Preservation: T 4" /4 g 13, .1,2L/ 6, 5
it )
A , * ;") 7 " 4- , "1,1 " Ai ■-•
Lt 0
4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
) and explain below.
COMMENTS - Explanation of noted items:
) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC Date
Page 37 of 38