|
..-r"swr, ..c,YYb['sr:. .- - „ - ....._.n•.... .. ..... .1K,t sir L:. a... e.k'.V~.'w. ~6 .. ..y9~?a.. ~ - .. ....~-. ... .. - - .
<br />• \,• •
<br />Page .1. of ~
<br />MINED LAND RECLAMATION DIVISION
<br />MONITORING FACT SHEET
<br />LABORATORY SAMPLES
<br />0 eration: -~ ,:icc C' / C-., O ~~ ,File (k: ~• ~(-J~7-
<br />Company/Address: /O,~ -T• TP,o., S~;f? 9oD P, U. ~~r ~-~79 Mine Contact :,~.',Y/ ,'c!-r,r
<br />Specialist:~ti. ,S'<h~.',.,,r C^o%i,;.~, S,~i.;..~r ~U 77I,7/ • ~G7?
<br />Date: G / /' Time: /:OUf~/'9_ Weather: C/t.c ~u„n~ ~ /
<br />' Comments: Gl.e!?l Sc.,n/~ f~~CC~ n,, G~i,l%G Laboratory: /~~ , {~r f.cb~/~/~r~!
<br />t /k Cic'c' K S ,N ~ ~
<br />1. site ID.: o,~~dGo6/I l Location: c,/?~ J
<br />Full Ground Water/Full Surface Water/Partial Sample/Geo. Soi /Grab Composite filtered/Raw
<br />/°/q /~; L
<br />Disposition:..So,,,O~P l,i~,S O/,cP~/in ~ ~~bl'/~~~ ~T~/.'~,c~i ~~q nn !/ Time: /.'oJ ~~'1~
<br />i ~ .~
<br />Sample Split: ?S Comments: S/~/cti in •; S/c'c'~ coo/~'!-
<br />Flow/Level: ~ pH: Temp. EC. /Other:
<br />2. Site ID.: vx~LG~7G //~ Location: t/i~ G2r,lC %o/7s~.~ !~,/~ /~Z'~r~°D,'l.
<br />r
<br />Full Ground Water/Full Surface Water/Partial Sample/Geo. Soi /Grab/Composit /Filtered/Raw
<br />Disposition:-Sa~.,p~~ r,/ns D~•cc':~.n c /n/JC'/~c/ ~,O/~clC h:~~~ ~„ri Time: /.'3J /-1:~~///'~.
<br />! r
<br />Sample Split:'?s 1~ Comments: f{~/~~=7/.n '; S/r'~'~ /~~/<'/'
<br />Flow/Level: / pH: Temp. EC. Other:
<br />3: Site ID.:O~~2(oOlo ll3 Location: ~/,~ e/dc`/C Oo~ ~?~7 C~ yu fS~nOP l~ ~C,PO7,~
<br />- Fu11-'Ground Water/Full Surface Water/Partial Sample/Geo. Soi /Grab Composite Filtered/Rpaw~//~~Vsf
<br />Disposition: Snh~~O~i wr%S Q~nl2c' in ~ ~n,/7P/dc~ ~,;9/~,~ l~ ~rq 4n `I Time: oZ;DD P~~~,
<br />Sample Sp1it:~cS J.G. Comments: S~~/r'.:~.ir _ Sf'c'~ cum/°r,
<br />Flow/Level: pH: Temp. EC. Other: /
<br />14. Site ID.:(~~,.Z.)/iBGlly' Location: .t//~C/.'~/C poh bCnl'~~ ,.rs~o0 acf~Q`_^.?~
<br />Full Ground 4later/Full Surface Water/Partial Sample/Geo.~Soil Grab Composit /Filtered/Raw//!/G
<br />Disposi[ion:Scl;,O~~ Ly,S D~nc2c~in n ~-pc%'~ ~,nl%cL bcq (:n~~ Time: o2:JJpµ~,
<br />J
<br />Sample Split: ~ >f / ~ Comments: S7/a/?r'f .~n r, S~2c'~ r»~~=.~ ,
<br />Flow/Level: pH: Temp. EC. Other:
<br />S. Site ID.:O~~'!GUU/? I Location:nC,GOni~~~i?c'1~ ^.n c/c'G 6?i1C~~ la ,'~'`'0~lh
<br />Full Ground Water/Full Surface Water/Partial Sample/Geo. So'-/Grab om osite Filte ed/Raw,y~
<br />~/ i,~.~:3J rM1~
<br />Disposition: sc,„ ~~~ w~ r D~cc~cy i~,, ,~ ~-;cr/c': ~ ~ ~ q/x lC pcO ^~ c/ Time.-~-T; ~'~ ~/
<br />Sam le S lit: ~ `J
<br />p p CS Comments: S/~c?n' i,t ,: S~eN~ Cao%'r-.
<br />Flow/Level: pH: Temp. EC. Other:
<br />#~' ~9~ m.
<br />dCHAIN~OF CUSTODY '.~^= ~ ?V y+7Sr,s•
<br />1.1."Transferred from: /o-,.-- ~r,,}~~ To: Time/Date:
<br />$1'. Transferred from: To: Time/Date:
<br />'Received at Lab by: Date:
<br />8934F
<br />\_ - -
<br />O O O Y R M O D Y A
<br />
|