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

Report Mail Address:
Cotter Corporation -Canon City Mill
PO Box 1750
Canon City, CO 81215 -1750
Contact Name: Frank Adamic
1- 719 - 275 -7413 ext. 209
[e-mail]
Sampler Name if other than Contact:
1 - 303 - 3893 mine phone
Bob Tennant 1- 719- 371 - 3009 -cell
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
Invoice Contact: JoAnne
1-719-275-7413 ext.
Ary
209
Purchase Order #:
ELI Quote #:
719- 275 -1669
Report Required For: POTW/VWVrP DW
Other
Special Report Formats — ELI must be notified prior to
sample submittal for the following:
NELAC A2LA Level IV
Other
EDD /EDT Format
K Number of Containers
y Sample Type:
AWSVBO
2.t gir, Water aoils/Solids,
yegetatlon, Bioassay Qther
; i,:_;s ,, : -.. s= -_4:: :...:__
SEE ATTACHED
Normal Turnaround (TAT)
a
RUSH Turnaround (TAT)
Notify ELI prior to RUSH sample
submittal for additional charges and
scheduling
Receipt Temp
o C
Total Suspended Solids 1
See Attached Table 1
Cooler ID(s)
Comments:
S&A schedule Code
DIS CODE #2
Table 1
On
T S ,Alk 1 do not run
S Alkalinity,Bicarbonate,Cyanide
,Gross Alpha- Beta,
Custody SeafY N
Intact Y N
Signature Y N
Match
LAB ID
SAMPLE IDENTIFICATION
(Name, Locati on, Interval, etc)
Collection
Date
Collection
Time
1 Sump 10
7/03/12
10:15
Water 7
x
Species Name
2 Dis- 001A ----A
7/02/12
8hr
composite
Water 1
Species Name
fir;
3
Species Name
<
Species Name
5
Species Name
_'
6
Species Name
Species Name
8
Species Name
-.
9
Species Name
{
10
Species Name
Custody
Record MUST
be Signed
Relinquished by: Bob TennantDate/Time: : 07/03/12 10:15
Shipped by
,
Received by: Date/Time:
Relinquished by: Date/Time: ,.c, v -1--C--1 L /for
Shipped by Fir,,, sal(
- -�
Received by: Date/Time:
Sample Disposal: Return to Client Lab Disposal
LABORATORY USE ONLY
Sample T .e # of fractions
iiiIBMChain of Custody and Analytical Request Record
LABORATORIES
Company Name: Cotter Corporation
Tracking No. 7585 giolir3 f
PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1
Project Name: Schwartzwalder
Monitoring Program
ATE: 7/5/12 SSTF: S26552 & S26513