INSPEC25686

• Permit No: C1981014
• IBM Index Class Name: Inspection
• Doc Name: INSPECTION REPORT
• Inspection Date: 9/29/1992
• Media Type: D
• Archive: No

Page _ of
MINED LAND RECLAMATION DIVISION
'I MONITORING FACT SHEET '
LABORATORY SAMPLES
Operation: _yt~ll-I} EC-~~ ~j +h.~ File ~k: C-~~-U/~'
Company/Address: ~a~ d4°t r`'l.0%;'.iCE Mine Contact: !~-V'~~j
Specialist:~i;{=7 -~-
'Date:'a~3U 9Z Time: II ~U Weather: C~~:<tll~
(Comments: Laboratory: G TC
1. Site ID.: iJJ~-~LC`Ij~3c:~ Location: GH(cCC h l•F I/C9 "~ rrL'rZ~ ~.:K-r-D r);rV~
P Jlr ~K.ri k- -
Full Ground Water/Full Surface Water/PIa'rtial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: frlldlYc•'~ w,`fL+c~ ~:-~/gr11+~1'~'~/JICr/ Time: ~/.; ~JCJ
Sample Split: ti~ Comments:
Flow/Level: ~j.gQ~h pH:~'Q' Temp.~`~ EC. ~/~U Other:
__T
2. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
3. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
4. Site ID.: Location:
Full Ground 4later/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
5. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
CHAIN OF CUSTODY ff n + r ~
1. Transferred from:~'~`6v~ .~ f"~l ~ To: ~ 9. /!~„ Time/Date: :~"~1/T <: ~~ ~v~
1. Transferred from: ~~} To: % Time/Date:
T 7~
Received at Lab by: '-~~ ~ ~J;~ ~ Date: ~/ ~~13- t/~ C~
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