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'SUBMIT'TAL AND TRACKING FORM
Sample Submittal s.2145 6
C: P.0.-.111011 .17 . . S:
c . a (Man
Sample Loc.HD Na. . 1(i 13
r ate.
Sample Date 1 S 1 s Time • 2
Collected By iea6 reit #1 G AI
Field Custodian go f Q.n 1
Delivered By
Received By
Date Recd.
Time Recd.
1 .
2.
Field Data - Preservation: f"` 2 • S ) 7. 22. (" 2 00 t id? s
riira co� -t� s, •6 - L�-� �. ) //= hi* o 2_ -.....
4. Date analysis required by (if not Bolding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
COd MKNTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO (
Sample Type: Air Water / Soil Other (specify):
Analysis - Test series requested: ('f
�., ,.:tt. ` ;:. :::�`
P.O. Box 1750 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:
F A #r¢. y L a o 0, 4 0 / e
2 3 1 3 114, 1 .c.,. Cr e Q 1/1 (.4J v.
ee: C P✓ 14/y 9 z"‘o(
) and explain below.
) If NO, explain:
Date
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