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C: P.O. Box 1750 <br />Canon City, CO 81215 <br />Sample Loc./ID No. $'4) i <br />Sample Date 9' 4 - r Time C ' 3 <br />Collected By f 11 „ , <br />Field Custodian ++''` mool.:, rIP /1 <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />1. Sample Type: Air Water 7 Soil Other (specify): <br />2. Analysis — Test series requested: re; 4 / <br />3. Field Data — Preservation: r / S 3 ph '7. 2. , 6_,...,.. • . '4 � 92 44 A <br />C c!. h /3 2(- c e: ,/ -1. s J 3 fi <br />O S J id. f14'4/e ,2,, sa^vi/ <br />25 r�U /i�l/J 2s ', G' /if z 4//: /-/ i <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( <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 />Sample Submittal <br />r �= s26562 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Callon City, CO 81215 Nucla, CO 81424 <br />. S _ / /// AA (' 7 f.7 2 . <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Lab Destination if not Cotter: <br />/ 6 S Ica (4 ) Id es: 7 6: ? / <br />) and explain below. <br />Date <br />Page 28 of 28 <br />,otter <br />1011.011,V yo0uuaarva <br />f� <br />r3" , 6 <br />7-" cr 4i( <br />fl LG.,'• <br />Ql4(IZ <br />[l 1if:. <br />C: P.O. Box 1750 <br />Canon City, CO 81215 <br />Sample Loc./ID No. $'4) i <br />Sample Date 9' 4 - r Time C ' 3 <br />Collected By f 11 „ , <br />Field Custodian ++''` mool.:, rIP /1 <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />1. Sample Type: Air Water 7 Soil Other (specify): <br />2. Analysis — Test series requested: re; 4 / <br />3. Field Data — Preservation: r / S 3 ph '7. 2. , 6_,...,.. • . '4 � 92 44 A <br />C c!. h /3 2(- c e: ,/ -1. s J 3 fi <br />O S J id. f14'4/e ,2,, sa^vi/ <br />25 r�U /i�l/J 2s ', G' /if z 4//: /-/ i <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />6. Invalidating circumstances? If YES initial ( <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 />Sample Submittal <br />r �= s26562 <br />S: P.O. Box 1750 N: P.O. Box 700 <br />Callon City, CO 81215 Nucla, CO 81424 <br />. S _ / /// AA (' 7 f.7 2 . <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Lab Destination if not Cotter: <br />/ 6 S Ica (4 ) Id es: 7 6: ? / <br />) and explain below. <br />Date <br />Page 28 of 28 <br />