Laserfiche WebLink
Company Name: Cotter Corporation <br />Tracking No. 3692013 61588774 <br />Project Name: Schwartz - <br />DATE: _7127111 SSTF: 525889-- S25896 <br />Contact Name: Randy Whicker <br />1- 719 - 275 -7413 ext. 210 <br />Sampler Name if other than Contact <br />1- 303 -642 -3893 mine phone <br />Bob Tennant 1 - 719 - 371 - 3009 - cell <br />Report Mail Address: <br />Cotter Corporation - Canon City Mill <br />PO Box 1750; Canon City, CO E <br />Invoice Address: <br />PO Box 1750 <br />Canon City, CO 81215 -1750 <br />Invoice Contact: JoAnne Ary <br />275 -7413 ext. 209 <br />Fax: 1 275 - 1669 <br />Purchase Order #: <br />ELI Quote #: <br />Report Required For: P <br />Other <br />Number of Containes <br />Sample Type: <br />AWSVBO <br />Sir, Water Sails/Solids, Yegetation, <br />X Bioassay Other <br />Nominal Turnaround (TAT) <br />Notify ELI prior to <br />RUSH sample <br />submittal for <br />R additional charges <br />t and scheduling <br />Recei T,Qmp <br />, L C <br />U - dissolved only - CODE #1 <br />U - total & dissolved - CODE #3 <br />Ra-226 total & dissolved CODE#3 <br />SEE ATTACHED TABLE 1 <br />Cgol r D(s)_i_ <br />CC „\L <br />Special Report Formats — ELI must be notified <br />prior to sample submittal for the <br />NELAC ❑ A2LA • Level IV 0 <br />Other <br />EDD /EDT ❑ Format <br />Custody Seal <br />Y / <br />Intact <br />Y <br />Signatur <br />Y <br />Match 14118 ID <br />Y / <br />RUSH Turnaround i <br />Comments: <br />SBA Schedule Code : <br />SW CODE 1 1 <br />Table 1 <br />T 1, <br />Tww c c000lele rs <br />SAMPLE <br />IDENTIFICATION <br />(Name, Location, <br />Interval, etc) <br />Collection <br />Date <br />Collection <br />Time <br />' SW AWD <br />7/27/11 <br />9:25 <br />Water <br />® <br />❑ <br />❑ <br />• <br />• <br />O <br />0 <br />• <br />❑ <br />• <br />0 <br />• <br />Code 1 <br />s SW A001 <br />7/27/11 <br />9:40 <br />Water <br />® <br />❑ <br />• <br />❑ <br />❑ <br />❑ <br />❑ <br />❑ <br />• <br />❑ <br />c- <br />❑ <br />Code 1 <br />SW BDIS <br />7/27/11 <br />10:55 <br />Water <br />❑ <br />• <br />• <br />0 <br />❑ <br />• <br />❑ <br />❑ <br />❑ <br />❑ <br />0 <br />❑ <br />Table 1 <br />° SW PL <br />7/27/11 <br />12:40 <br />Water <br />® <br />❑ <br />❑ <br />0 <br />• <br />❑ <br />❑ <br />• <br />• <br />• <br />" <br />0 <br />Code 1 <br />SW OS <br />7/27/11 <br />12:45 <br />Water <br />® <br />• <br />• <br />0 <br />• <br />❑ <br />0 <br />❑ <br />0 <br />❑ <br />0 <br />❑ <br />Code 1 <br />e sw BOS <br />7/27/11 <br />12:55 <br />Water <br />® <br />❑ <br />❑ <br />• <br />❑ <br />❑ <br />0 <br />• <br />❑ <br />• <br />0 <br />❑ <br />Code 1 <br />SW GS <br />7/27/11 <br />14:35 <br />Water <br />0 <br />• <br />• <br />❑ <br />• <br />❑ <br />• <br />❑ <br />❑ <br />❑ <br />0 <br />❑ <br />Code 1 <br />SW BPL <br />7/27/11 <br />14:40 <br />Water <br />0 <br />❑ <br />❑ <br />• <br />❑ <br />• <br />❑ <br />❑ <br />❑ <br />❑ <br />o <br />❑ <br />Code 1 <br />0 <br />0 <br />0 <br />• <br />0 <br />0 <br />0 <br />0 <br />• <br />0 <br />0 <br />0 <br />10 <br />• <br />0 <br />• <br />0 <br />❑ <br />D <br />O <br />❑ <br />❑ <br />■ <br />u0 \053 <br />Custody <br />Re orde <br />MU <br />Signed <br />Relinquished by: Bob Tennant Date/Time:7/27 /11 17 30 <br />. 00 <br />Sh pped by: <br />Sh'pped by: <br />Received by: 4 Date/Time: <br />Received by: , Date/Time: <br />Relinquished by: Date/Time: <br />Sample Disposal: Retum to Client • Lab Disposal 0 <br />LABORATORY USE ONLY <br />_ Sample Type # of fractions <br />Chain of Custody and Analytical Request Record <br />PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1 <br />6£ 1 Oe a6ed <br />