Laserfiche WebLink
%,Mawr <br />vu•MUO aiwwARUMU <br />6 a 4lp„ .it 4 1 f <br />e <br />. cell, <br />y l <br />:) <br />ti. 7 Aiikg <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal <br />C: P.O. Box 1750 <br />Canon City, CO 81215 // <br />Sample Loc./ID No. S IS PL <br />Sample Edda q` /1 ' f" Time f <br />Collected By I a g (.O pi ,1 a ..s <br />Mkt Cwstodian A to 7490, A' - <br />Delivered By <br />Received By <br />Date Recd.' <br />That Rod. <br />w <br />1. Sample Type: Air Wate3'"-f Soil • Other (specify): <br />2. Analysis - Test series requested: e• 1Q / <br />. 8`ield. Hato - Preservation: <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? It YES initial ( ) and explain below. <br />COMMENTS - Explanation of noted items: <br />' ( ) Check if additional attachments. <br />QA Review: <br />Sa4nple valid? - YES ( ) NO ( <br />QAC <br />5 21443 <br />S: P.O. Box 1750 <br />Canon City, CO 81215 Nacla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Cotter: <br />L`i � c..c i�G �S . C <br />• <br />23 1 ��' 7�'" e �r 4 I✓ <br />teo v.f k'y. gz.Cat <br />" <br />) If NO, explain: <br />Date <br />N: P.O. Box 70 <br />Page 8 of 't© <br />