Laserfiche WebLink
\,V«cr <br />vaa -viac amco .wa&,v.. <br />1 '_ <br />/ <br />? r <br />1 :2o <br />'4- <br />C: P.O. Box 1750 <br />Canon City, CO 81 215 <br />Sample Loc./ID No. 3 )411— <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal ::2 S 25915 <br />Sample Date g" /7-2w/rime / 74 11 y0 <br />Collected By 404 2 ; 2 vA/ G A <br />Field Custodian ./`ZO Th" <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />3. Field Data — Preservation: 1 <br />r / 4/ (Q ' ( off, ,3. G 2. c. <br />f- 0.99 <br />S: <br />1. Sample Type: Air Water Soil Other (specify): <br />2. Analysis — Test series requested: a 00 <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( <br />QAC <br />P.O. Box 1750 N: P.O. Box 700 <br />Canon City, CO 81215 Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />2 313 , �.../ Cf ei <br />p, <br />(6 S , lr i fr' k 16 Of <br />4 J Z - k° i v. s I f/9 / ` /WO 7 7. c. ,, <br />) and explain below. <br />COMMENTS — Explanation of noted items: <br />) If NO, explain: <br />Date <br />dye )O U <br />