2012-08-02_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 8/2/2012
• Doc Name: SURFACE WATER DATA FOR APRIL 2012
• From: COTTER
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

Company Name: Cotter Corporation
Tracking No.3692013 61634495 & 71
Project Name: Schwartz -
DATE: 4/05/12 SSTF: 526451-- S26458
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 812
Contact Name: Randy Whicker
1- 719- 275 -7413 ext. 210
Sampler Name if other than Contact:
1- 303 -642 -3893 mine phone
Bob Tennant 1 719 - 371 - 3009 - cell
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
Invoice Contact: JoAnne Ary
75 - 7413 ext. 209
Fax: 275 - 1669
Purchase Order #:
ELI Quote #:
. g . c
Report Required For: POTWNVWTP
Other
c Number of Containers
y Sample Type:
RI AWSVBO
Air, Water $oils/Solids, vegetation,
X ¢ioassay Other
AN f;,, i ,.: REQUESTED
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
p additional charges
. and scheduling
Receipt Temp
y 3 C
U - dissolved only - CODE #1
U - total & dissolved - CODE #3
Ra-226 total & dissolved CODE#3
SEE ATTACHED TABLE 1
Cooler ID(s)
L1.
Special Report Formats — ELI must
prior to sample submittal for the following:
NELAC El A2LA A2LA ❑ Level I
Other
EDD /EDT ❑ Format
•
Custody aI
Y /ND
Intact
Y / N
Signature
Y / N
Match LAB ID
Y / N
i RUSH Turnaround
Comments:
S&A Schedule Code :
SW CODE I 1
Table 1
coolers Frequency' 1,
Two
Two c
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
1 SW AWD
4/05/12
10:05
Water 7
❑
•
❑
0
•
❑
❑
■
❑
❑
0
❑
Table 1 ..-
2
SW AO01
4/05/12
8:00
Water 1
0
•
•
•
❑
•
•
■
❑
0
®
•
Code 1
1 s
3 SW BDIS
4/05/12
8:20
Water 1
®
0
•
•
❑
•
❑
•
❑
0
❑
Code 1
L
° SW PL
4/05/12
8:25
Water 1
0
❑
•
•
•
•
❑
•
❑
❑
=o
❑
Codel
s
5 SW OS
4/05/12
8:35
Water 1
0
❑
•
•
❑
❑
•
•
•
❑
®
❑
Code 1
>.
6 SW BOS
4/05/12
9:25
Water 1
0
0
•
❑
❑
.
•
❑
❑
❑
0
❑
Code 1
4 " �I;b `10313
r' c., .
0
CG
r
SW GS
4/05/12
9:35
Water 1
0
❑
❑
•
❑
•
❑
•
❑
❑
IN
❑
Code 1
e SW BPL
4/05/12
10:35
Water 7
0
❑
•
0
❑
❑
•
❑
❑
❑
0
•
Table 1
9
•
❑
•
❑
❑
❑
❑
•
•
❑
•
•
..�.a
10
0
0
0
•
0
m
0
0
0
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:4/05/12 16:30
Shipped by: FedEx
Shipped by:
_
Received by: Date/Time:
Relinquished by: Date/Time:
Received by: xG,sic Date/Time: Lg. ); /al?e
Sample Disposal: Return to Client ❑ Lab Disposal N
LABORATORY USE ONLY
Sample Type # of fractions _
Chain of Custody and Analytical Request Record
PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1