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L,pitCr <br />via uaac a <br />IWOrnm..rvan <br />la -10 -1 ! <br />(a'7 <br />4r: <br />G•.r.sc <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 NI S 2 tI <br />C: P.O. Box 1750 <br />Cafion City, CO 81215 <br />Sample Date 10 6 — Time // <br />Collected By 1, t: 1 fir' •-efir e i f <br />Field Custodian la <br />S: <br />fif ) <br />' ' <br />1. Sample Type: Air Water ( " Soil <br />2. Analysis - Test series requested: 1 `y J <br />6. Invalidating circumstances? If YES initial ( <br />P.O. Box 1750 <br />Cation City, CO 81215 <br />( ,k ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC Date <br />N: P.O.Box700 <br />Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />'•k f <br />1r <br />Other (specify): <br />3. Field Data - Preservation: , 1 4 4 ` ' f 3/8 L �c <br />//54 ,+ + R,J+, R). ° ?• ^ :.t / L T f j /64 ' f 2. •' ..,. . <br />24: // _ / L- 1d1I91 e j ; L),, <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />) and explain below. <br />"0 11 <br />COMMENTS - Explanation of noted items: <br />