2012-09-04_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 9/4/2012
• Doc Name: SURFACE WATER DATA FOR 06/2012
• From: COTTER
• To: DRMS
• Email Name: TAK
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal !2 S 2.5 ti
C: P.O. Box 1750 S: P.O. Box 1750
Canon City, CO 81215 // Canon City, CO 81215
Sample Loc./ID No. et � P`
Sample Date 6 - 2O /4 - / a_ Time �
Collected By R < To�,4 c1
Field Custodian Ail' 1;
Delivered By
Received By
Date Recd.
Time Recd.
1.
2.
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
�
E� Pr y C - G .4 ✓G /Lt.* • '
239? Sc/ �
b./7 7—Kci
M �f
G -
Sample Type: Air Water 1 Soil Other (specify):
Analysis - Test series requested: ( /'e
3. Field Data - Preservation: T fl 7. ,.Z. ("c
/ r
: QdZ O. 5 F/4 ffNa, � .
0. - c7
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 Date
N: P.O. Box 700
Nucla, CO 81424
Page 8 of 8
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COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal !2 S 2.5 ti
C: P.O. Box 1750 S: P.O. Box 1750
Canon City, CO 81215 // Canon City, CO 81215
Sample Loc./ID No. et � P`
Sample Date 6 - 2O /4 - / a_ Time �
Collected By R < To�,4 c1
Field Custodian Ail' 1;
Delivered By
Received By
Date Recd.
Time Recd.
1.
2.
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
�
E� Pr y C - G .4 ✓G /Lt.* • '
239? Sc/ �
b./7 7—Kci
M �f
G -
Sample Type: Air Water 1 Soil Other (specify):
Analysis - Test series requested: ( /'e
3. Field Data - Preservation: T fl 7. ,.Z. ("c
/ r
: QdZ O. 5 F/4 ffNa, � .
0. - c7
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 Date
N: P.O. Box 700
Nucla, CO 81424
Page 8 of 8