2012-08-06_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 8/6/2012
• Doc Name: GROUNDWATER DATA FOR SECOND QUARTER 2012
• From: COTTER
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

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COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
C: P.O. Box 1750
Cafion City, CO 81215
Sample Loc./ID No. fria - 0 a
Delivered By
Received By
Date Recd.
Sample Submittal
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Sample Dated:" ? Z Time f 4 :3 0
Collected By 1304 �i°.11 ,, c.
Field Custodian Zo 7ios, -14
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P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Noels, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
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1. Smile Type: Air Water ( o Soil Other (specify):
2. : Analysis — Test series requested: T 4 /e .
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3. Field Data — Preservation: °'' T /� J � � � � D � �
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4. Dam 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
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