2013-06-05_HYDROLOGY - M1977300

• Permit No: M1977300
• IBM Index Class Name: HYDROLOGY
• Doc Date: 6/5/2013
• Doc Name: Surface Water Data for April 2013.
• From: Cotter
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: TAK
• Media Type: D
• Archive: No

A.rORATION SAMPLE SUBMITTAL AND TRACKING FORM
Sample Submittal _ i 4. S �
C: P.O. Box 1750 S: P.O. Box 1750 N: P.O. Box 700
Caiion City, CO 81215 Caiion City, CO 81215 Nucla, CO 81424
J) i
Sample Loc./ID No. � Lab. No.(s) }'
Sample Date �' ;' `� Time -'
Collected By mkt_
Field Custodian"
Delivered By
Received By
Date Recd.
Time Recd.
Sample Type: Air Water Soil
Analysis - Test series requested: (-
l.V«Ol
to • i t�� /
vl■ -O■M Lw�auw■wu
-. !'r �
�)
1 i ii1
(�\
l
w
Date Data Entered }
Data Entry By '
Laboratory Destination if not Cotter:
1.
2.
3. 1
4.
5.
Other (specify):
Date analysis required by (if not Holding Time): .
Special handling conditions or other instructions:
6. Invalidating circumstances? If YES initial
COMMENTS - Explanation of noted items:
) and explain below.
( ) Check if additional attachments.
QA Review:
Sample valid? YES ( ) NO ( ) If NO, explain:
QAC
Date
Page 11 of 16