Laserfiche WebLink
a.vaaCr <br />aae��se I1V IW uva <br />06 0' 4.4.1 A/ A (-f <br />a�fe r- <br />'PIE A- <br />4,g -- l/ <br />FeG <br />!a: !s <br />lra L— 1 <br />C: P.O. Box 1750 S: P.O. Box 1750 <br />Canon City, CO 81215 Canon City, CO 81215 <br />Sample LocJID No. <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal IL' $ 25 9011 <br />Sample Date g%+ al / Time . S Date Data Entered <br />Collected By 404 4 7 AL, Data Entry By <br />Field Custodian /;504 Laboratory Destination if not Cotter: <br />1. Sample Type: Air Water • !! Soil Other (specify): <br />2. Analysis — Test series requested:�ead4 <br />3. Field Dnta - Preservation: f . b A 77 Ca,,/ 2 77 td 5 S <br />r CAA/ vA L >-.` 1.6 /C- F4 #A/4 <br />24 1 .f , 1. s" L ' , ,�t ,fra, 7s f / + /= <br />/Lee,! try.5'a 5" j a 3,L C'/ 4 A/clJ /-1 7. <br />4. Date analysis requir 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 <br />N: P.O. Box 700 <br />Nucla, CO 81424 ' <br />Lab. No.(s) <br />, La ham 4? d 1 o s I... <br />23 `' f di" ere e v <br />g.. -10 / <br />Page 41 of 41 <br />