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COLORADO DEPARTMENT nF i,FALTH <br />Water Quality Control Division <br />(Sample Collected by MLRD) <br />Water Lab No. <br />(From Water Qua Data Sheet <br />ENFORCEMENT MONITORING FACT SHEET <br />1. Name of Company: ,~.~ s <br />2a. Name of Mine: oe.,e,z, <br />3. Date of Contact: S- q. <br />5. Mine contact/title ad ress: <br />2. NPDES Permit#:[p~~iG'/_~?_ <br />2b. MLRD Permit#: c-gl_p~ ~ <br />4. Time of Contact: /ooo <br />6. Phone: ~T~~(_,S79S" /. Inspector/Sampler: <br />8. Date an3 Ttme of Samp inT g: 8'S-Ra 1330h.~, <br />9. Does Mine Representative wish to be present?: ~~ <br />10. If so, list name, title, and phone: ~//~ <br />~, <br />11. Does the Operator wish a sample split? ~--- Initials: <br />12. Will the Operator provide container? Initials: <br />13. Are there any special arrangements to meet at site? <br />14. Parameters to be Monitored: Total Suspended Solids pH <br />Temperature Settleable Solids Iron anganese <br />Other (list): <br />15. Type of Sample: Grab Composite Describe ocation Samp a was <br />taken: ~J.,,~I-lob ~ ~. c~~,.~f~. (/ ~// ~l.«L,ar-Qe D~n~ <br />16. Containers: ~ Plastic containers w/o acid Size: I <br />___~_ Plastic containers acidified w/HN03 Size: I <br />Other: <br />17. Name & Title of Persons Present During Sampling: c ~ c SG,,.,, <br />I L°G (aM,a {..o S~~ng <br />18. Was sample split? /d0 ~- <br />19. Who Received or Denied Sp it Name,Ttt e, Initta s pxs, Qu ~ a~g ,~ <br />zu. utsposttton of sample at ter coi lectton: , e~+ s„ ,« ,,, e,-r~Ie.~ ,•~ <br />~« oo~ ~/r D~Gf Kn ~~ ~P~~~r <br /> <br /> <br />Transferred From: To: Time Date: / yr ; a <br />Transferred From: To: Time/Date: <br />Transferred From: To: Time/Date: <br />Transferred From: To: Time/Date: <br />Received at Lab by: Time/Date: <br />Comments: <br />Note: If Laboratory ana ysts o the a ove menttone samp a to tcates a <br />violation of the "Water Quality Control Act", or other State or Federal water <br />quality Laws, these results may be used in the future for enforcement actions. <br />Signature of Sampler: <br />r~ <br />QI `i3') <br />Doc. # 8683E-B <br />