2012-01-23_HYDROLOGY - M1977300 ‎(3)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 1/23/2012
• Doc Name: COTTER MONTHLY & QUARTERLY DATA, PART 1 OF THREE
• From: COTTER
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

C: P.O. Box 1750
Cafion City, CO 81215
Sample Loc./ID No.
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal r :2 S miss
S: P.O. Box 1750 N: P.O. Box 700
Cafion City, CO 81215 Nucla, CO 81424
� ti6- S Lab. No.(s)
Sample Date r. ' (i -..2 ` ., / Time /co. ' ` ' ' _ Date Data Entered
Collected By I ,I, / '• A: A ' e ..1f r Data Entry By
_
Field Custodian /i =t 4 9 " �� e 1, t Laboratory Destination if not Cotter:
Cotter Off Si te Destiaation , L c 5 x ` ^ ` '' ' -4.. r
Delivered By r ,
Received By " '
Date Recd.
Time Recd.
N C 1
1. Sample Type: Air Water / Soil Other (specify):
2. Analysis - Test series requested:
3. Field Data - Preservation:. / 1 ' t$ "" t ' ? . g K. : 1 ; e .
' �
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 19 of 20
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C: P.O. Box 1750
Cafion City, CO 81215
Sample Loc./ID No.
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal r :2 S miss
S: P.O. Box 1750 N: P.O. Box 700
Cafion City, CO 81215 Nucla, CO 81424
� ti6- S Lab. No.(s)
Sample Date r. ' (i -..2 ` ., / Time /co. ' ` ' ' _ Date Data Entered
Collected By I ,I, / '• A: A ' e ..1f r Data Entry By
_
Field Custodian /i =t 4 9 " �� e 1, t Laboratory Destination if not Cotter:
Cotter Off Si te Destiaation , L c 5 x ` ^ ` '' ' -4.. r
Delivered By r ,
Received By " '
Date Recd.
Time Recd.
N C 1
1. Sample Type: Air Water / Soil Other (specify):
2. Analysis - Test series requested:
3. Field Data - Preservation:. / 1 ' t$ "" t ' ? . g K. : 1 ; e .
' �
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 19 of 20