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l..uLiei <br />vu-vuc ,�cauua wvn <br />gd 6 7: t <br />A e=9, //_`' <br />,./i; <br />CA) <br />? -c 3 <br />'°/(V <br />COTTER CORPORATION SAMPLE SUBMITTAL AND TRACKING FORM <br />C: P.O. Box 1750 <br />Canon City, CO I � 8812215 4l <br />Sample Loc. /ID No. ' t/ S/ 4 <br />Sample Date 1" / -20g Time <br />Collected By ,ecj ,nil Ti <br />Field Custodian / ) „el,/ G <br />Delivered By <br />Received By <br />Date Recd. <br />Time Recd. <br />( ) Check if additional attachments. <br />QA Review: <br />Sample valid? YES ( ) NO ( <br />QAC <br />Sample Submittal <br />S: P.O. Box 1750 <br />Canon City, CO 81215 <br />t _ t <br />T <br />6. Invalidating circumstances? If YES initial ( <br />1'2 sting <br />N: P.O. Box 700 <br />Nucla, CO 81424 <br />Lab. No.(s) <br />Date Data Entered <br />Data Entry By <br />Laboratory Destination if not Co ter: <br />F „Q./(' / Zc( -'.0 - ✓r . •� ,/ ■ C <br />r ` <br />? ? <br />3 e. / CA, A / -t1 - <br />e - S o/ it/ <1TCO <br />1. Sample Type: Air Water Soil Other (specify): <br />/ <br />2. Analysis — Test series requested: C' r c P <br />3. Field Data — Preservation: r ' - 2, 6 ' `/ 7 V0 ` ^ / Z /8'. <br />u S 7,- <br />Al SA j x,63 f... 7, ` t I 3 0. G <br />().S —L /C4 7 g 4 - _f <br />4. Date analysis required by (if not Holding Time): <br />5. Special handling conditions or other instructions: <br />) and explain below. <br />COMMENTS — Explanation of noted items: <br />) If NO, explain: <br />Date <br />Page. 8 of R <br />