Laserfiche WebLink
L.w.SCE <br />VU!'011C i,CSauiuun <br />, r.)s // .,,�CAt <br />/4'316 <br />v d13 <br />:f - ,X <br />T r y r <br />' si 6 Tim- <br />Delivered By <br />Received By <br />Shiite Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal <br />C: I.O: UK 1750 S: <br />Chit City, CO 81215 <br />Sample LocJID No. '4. 9 <br />Sample Date i f " // 4 2 % . T h n e / 0 / <br />Collected By d 4 I •tom - � � es •rA • <br />/ <br />Field Custodian iS •.0 3.44' <br />6. Invalidating circumstances? If YES initial ( <br />{ ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( <br />QA'C <br />S 2 <br />P.O. Box 1750 N: P.O. Box 798 <br />Canon City, CO 81215 Nada, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />4 , 4 4 if le 4r r., <br />?! sc./74 Cr /4.cl <br />� . % j 4 f! SZCQI <br />Wirt. Sample Type: Air Water bP Son Other (specify): <br />2. . s sis - Test series req ed: n 6 <br />o rt./ s". 95- r a...-4,,e• 3 <br />Hate aslslysis required by (if•not Holdag Time): <br />S. - Spethiiisminfing conditions or other instructions: <br />) and explain below. <br />COMMENTS - Explanation of noted items: <br />) If NO, explain: <br />Page 18 of 19 <br />