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l.0LCCF <br />vai•�7 /mama&lawn <br />�y <br />ACS ; .4% 7 A/d✓6 ./! <br />l 4t if), <br />f » L' <br />fed Fir 'rho <br />C: P.O. Box 1750 S: P.O. Box 1750 <br />Canon City, CO 81215 Canon City, CO 81215 <br />Sample Loc./ID No. <br />Sample Date g ' / 7 .2 ad Time i ' S — <br />Collected By AO , 7Q �✓i✓� �- 1 <br />Field Custodian doh rp 1- <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />1. Sample Type: Air Water / Soil Other (specify): <br />( <br />2. Analysis - Test series requested: , Q { <br />3. Field Data - Preservation: To f 7. y '� #1 7 5 (2c2 ^ 6' • 3 7 / <br />r i/t/ s 2.26 G c■t.t , ` j 0. S " L FA /t.18 <br />2. 5.. <br />7 <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 />COMMENTS - Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( <br />QAC <br />Sample Submittal <br />:;2 S25916 <br />(-, <br />) and explain below. <br />N: P.O. Box 700 <br />Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />FA, _ <br />3 S'3 ' I (' C. e4 ,/r <br />J 4 /y czco <br />) If NO, explain: <br />Date <br />