2012-12-17_HYDROLOGY - M1977300 ‎(3)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 12/17/2012
• Doc Name: Groundwater Data for Third Quarter 2012- Section 3
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal
C: P.O. Box 1750 S:
Canon City, CO 81215
Sample Loc./ID No. .c4.4 Gr i JO -
Sample Date 9- t-} ' t.2 Time a:3 c
Collected By / 3 0 ro, A < -z 1
Field Custodian �. 7 .» l�-�
Delivered By
Received By
Date Recd.
'rime Recd.
R d .
Off S
1. Sample Type: Air Water Soil
2. Analysis - Test series requested: T 4 /r
Q
3. Field Data - Preservation: / 6 • `� l� �•
r.h r ''. ; :� 722" x 5
/-' //O-t 6 - / L / / G C.4
4. Date analysis required by (if not Holding Time);
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Nucla, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cot er:
i r L r -
d it r [� i1✓ .! • t L
C"" •I. s c , £ Jy' C 7 CO/
QAC Date
Other (specify):
rre} 1,0 v d,J( l ,I.
0, 20
) and explain below.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
Page 21 of 21
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COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal
C: P.O. Box 1750 S:
Canon City, CO 81215
Sample Loc./ID No. .c4.4 Gr i JO -
Sample Date 9- t-} ' t.2 Time a:3 c
Collected By / 3 0 ro, A < -z 1
Field Custodian �. 7 .» l�-�
Delivered By
Received By
Date Recd.
'rime Recd.
R d .
Off S
1. Sample Type: Air Water Soil
2. Analysis - Test series requested: T 4 /r
Q
3. Field Data - Preservation: / 6 • `� l� �•
r.h r ''. ; :� 722" x 5
/-' //O-t 6 - / L / / G C.4
4. Date analysis required by (if not Holding Time);
5. Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial (
P.O. Box 1750 N: P.O. Box 700
Canon City, CO 81215 Nucla, CO 81424
Lab. No.(s)
Date Data Entered
Data Entry By
Laboratory Destination if not Cot er:
i r L r -
d it r [� i1✓ .! • t L
C"" •I. s c , £ Jy' C 7 CO/
QAC Date
Other (specify):
rre} 1,0 v d,J( l ,I.
0, 20
) and explain below.
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
Page 21 of 21