2013-03-18_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 3/18/2013
• Doc Name: Surface Water Data for January 2013
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

Company Name: Cotter Corporation
Tracking No 3692013 62583471
Project Name: Schwartz -
DATE: 1/16/13 SSTF: S26765 & S26766
Report Mail Address:
Cotter Corporation - Canon City Mill
PO Box 1750; Canon City, CO 81215 -17:
Contact Name: Frank Adamic
- 1-719-275-7413 ext. 204
Sampler Name if other than Contact
1- 303 -642 -3893 mine phone
Bob Tennant 1 -719- 371 - 3009 -cell
Invoice Address:
PO Box 1750
Canon City, CO 81215 -1750
Invoice Contact JoAnne Ary
3 ext. 209
Fax: 669
Purchase Order#:
ELI Quote #:
Report Required For. POTW/Wti
Other
Number of Containers
Sample Type.
I-1 AWSVBO
Air, Water $oiis&Solids, Vegetation,
>4 Bioassay Other
ANALYSIS R ai.lt- ES9
Normal Turnaround (TAT)
Notify ELI prior to
RUSH sample
submittal for
P additional charges
t and scheduling
c
Re pt Temp
ttpp o C
U - dissolved only - CODE #1
U - total & dissolved - CODE #3
Ra -226 total & dissolved CODE#3
eigei
C I r ID(s)
� lpl -�-
Special Report Formats — ELI must be notified
prior to sample submittal for the following
NELAC ❑ A2LA ❑ Level IV
Other
EDD /EDT ❑ Format
Custody Seal
Y / N
Intact
Y / N
Signature
Y / N
Match LAB ID
Y / N
RUSH Turnaround
Comments:
SBA Schedule Code :
SW CODE I 1
Table 1
Frequency 1,
SAMPLE
IDENTIFICATION
(Name, Location,
Interval, etc)
Collection
Date
Collection
Time
' SW -AWD
1/16/13
10:15
Water 1
®
•
•
•
•
•
•
•
•
❑
0
•
2 SW -BPL
1/16/13
10:25
Water 1
0
❑
•
•
•
❑
❑
•
❑
❑
0
❑
3
•
•
•
❑
❑
■
■
.
■
■
.
■
1c
4
•
•
❑
■
•
•
•
•
❑
■
❑ � ❑
5
•
❑
■
■
❑
■
❑
■
❑
■
❑
■
r>. re
6
❑
•
❑
•
•
❑
•
•
❑
❑
•
❑❑
7
•
❑
•
•
•
❑
.
❑
❑
•
•
•
,
Ita
ce
8
D
O
D
.
O
D
U
D
•
0
0
•
ra
s
U
D
D
U
•
❑
❑
❑
•
I
•
❑
,
to
•
•
❑
❑
❑
•
❑
•
•
❑
❑
•
Custody
Record
MUST be
Signed
Relinquished by: Bob Tennant Date/Time:1 /16/13 16:30
Shipped by: FedEx
Shipped by:
Received by: Date/Time:
Relinquished by: Date/Time:
Received by: ate/Time: f f7-(3‘
Sample Disposal: Return to Client ❑ Lab Disposal Ci
LABORATORY USE ONLY
Sample Type # of fractions
Chain of Custody and Analytical Request Record
PLEASE PRINT; provide as much information as possible. Refer to corresponding notes on reverse side. Page 1 of 1