2012-08-06_HYDROLOGY - M1977300 ‎(2)‎

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

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COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Cation City, CO 81215
.Sample LocAD No 4 t D
Saaslle Rate S - Time 0 • D`)
Collected By go / P.iA e
Field Custodian 14 L re 4 44 Ii t
Delivered By
Revd By
Date Recd.
Time Recd.
fry Ct,
1. Sample Type: Air Water r;. _ Soil Other (specify):
2. Analysis - Test series requested: 4 4 /
3. Field Data - Preservation: T s - 0 '7, $ f Zoo £ ,5 4 I "`
ri�r c e ee Z.17 ,J -. , -. 9 '70 1 a/W/1M 2 d
1 L. E , /. 2 S 6- tI l sir //d41 �. S r /6- t; 1 L f F /t So
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 ( ) IIf NO, explain:
QAC
Sample Submittal
!4 $26451
O
N: P.O. Box 700
Callon City, CO 81215 Nucla, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
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