2012-08-06_HYDROLOGY - M1977300 ‎(3)‎

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

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«,,.COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal N2 s26474
C: P.O. Box 1750 S:
Canon City, CO 81215
Sample LocJID No. 5 Ag /
Sample Date S + 'g.a■ /Z Time 9' 00
Collected By " c, I
. Field Custodian 4 4 h n c....I
Delivered B
Received By
Date Recd.
Time Recd.
a N 4 . -
1. Sample Type: Air Water / Soil Other (specify):
2. Analysis — Teat series requested: C; C/ .e /
3. Field Data — Preservation: ! e C 9 r 71 / el r. ri. Z S 1 GI e c_ - v 1.
,rrA . f C �rJ 1. S'1,�' J. -`, D.s 4,f- 'rf ,V ,..0
AJ4. 2 . S'...«
54 !
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 ( ) If NO, explain:
QAC
P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Nucia, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
PA e? L4 (O,* f j iJn #' "...Lc.
Z3 C,reedo 4' i.
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