2012-12-17_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 12/17/2012
• Doc Name: Groundwater Data for Third Quarter 2012- Section 1
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

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Sample Loc./ID No.
Delivered By
Received By
Date Recd.
Time Recd.
COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal 5t $$2S
C: P.O. Box 1750
Canon City, CO 81215
Sample Date S - 3 / ` /2 Time S�
Collected By Ac:44 r" 7 - c 1
Field Custodian /S4 C d+ f
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1. Sample Type: Air Water (� // Soil Other (specify):
2. Analysis - Test series requested: re / r .
3. Field Data - Preservation:
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/ C: G�ri�� (4J ) t
4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO (
QAC
S: P.O. Box 1750 N: P.O.Box700
Cafion City, CO 81215 Nucla, CO 8142,4
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cotter:
5 --
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23 C" ' /
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r1 < .-.0 3 ` 667`4) /9. 7'd, r.... -p. Ir 0 ' 7'
A/ CJ .?, ().-+ ,a /z1;.. 7 L (/ f
) and explain below.
COMMENTS - Explanation of noted items:
) If NO, explain:
Date
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