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Dsts Reed. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal U S2 6436 <br />C: ! P.O. Box 1750 <br />Cation City, CO 81215 <br />Sample Loc•IID No. _fir ,4 4 D <br />Sample. Bute 4 11 "2/ Tine ► � Date Data Entered <br />Collected By )30 6 iF'.+ A 4.11 <br />n f' Data Entry By <br />Field Custodian Ao4, 7'� rr a 4 t Laboratory Destination if not Cotter: <br />Cotter Of[ illte lkstiaation L d 'b e). c am• �° t r,. ..- / <br />Dellvered By � I q Jt Sat ere v + k rT `4f , <br />Received y c . ri S t.- , JAJ� ' Z 62 <br />S: P.O. ilea 1751 N: P.O. Box 700 <br />Cation City, CO 81215 Nnela, CO 81424 <br />2. ' Analysis — Test series requested: ( t' <br />Lab. No.(s) <br />Tiros teed. <br />�j ® T � <br />1. Sample Type: Air WpYe Soil Other (specify): <br />3. Hold Data - IAr+diervation: re' Q. 0 g l7 ; 4 -+� <br />in re e0.4 e 2.2 i j i r '- / O. S- . / /f /a a,s �...� t . <br />4 "e <br />4. Date analysis required by (if not Holding Time): <br />S. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS — Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC <br />• <br />• <br />Date <br />•PageiOaf.10 <br />ti-13-11. <br />Dsts Reed. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />Sample Submittal U S2 6436 <br />C: ! P.O. Box 1750 <br />Cation City, CO 81215 <br />Sample Loc•IID No. _fir ,4 4 D <br />Sample. Bute 4 11 "2/ Tine ► � Date Data Entered <br />Collected By )30 6 iF'.+ A 4.11 <br />n f' Data Entry By <br />Field Custodian Ao4, 7'� rr a 4 t Laboratory Destination if not Cotter: <br />Cotter Of[ illte lkstiaation L d 'b e). c am• �° t r,. ..- / <br />Dellvered By � I q Jt Sat ere v + k rT `4f , <br />Received y c . ri S t.- , JAJ� ' Z 62 <br />S: P.O. ilea 1751 N: P.O. Box 700 <br />Cation City, CO 81215 Nnela, CO 81424 <br />2. ' Analysis — Test series requested: ( t' <br />Lab. No.(s) <br />Tiros teed. <br />�j ® T � <br />1. Sample Type: Air WpYe Soil Other (specify): <br />3. Hold Data - IAr+diervation: re' Q. 0 g l7 ; 4 -+� <br />in re e0.4 e 2.2 i j i r '- / O. S- . / /f /a a,s �...� t . <br />4 "e <br />4. Date analysis required by (if not Holding Time): <br />S. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( ) and explain below. <br />COMMENTS — Explanation of noted items: <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( ) If NO, explain: <br />QAC <br />• <br />• <br />Date <br />•PageiOaf.10 <br />