2013-03-14_HYDROLOGY - M1977300 ‎(2)‎

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 3/14/2013
• Doc Name: Surface Water Data for December 2012
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

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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. () r k."--
Sample Date 1 . 2 - Time
Collected By L, t, om„ ., r 9Y-5—
Field Custodian ' =
Delivered By
Received By
Date Recd.
Time Recd.
Sample Type: Mr
3. Field Data - Preservation:
QAC
2. Analysis - Test series requested: l . .
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6. Invalidating circumstances? If YES initial (
COMMENTS - Explanation of noted items:
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO (
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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 Cotter:
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) and explain below.
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Water Soil Other (specify):
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4. Date analysis required by (if not Holding Time):
5. Special handling conditions or other instructions:
) If NO, explain:
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