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• • Page I of I MINED LAND RECLAMATION DIVISION III'IIIIIIIIIIIIII~ MONITORING FACT SHEET !!~~ II LA60RATORY SAMPLES 999 gyration: ELwrti F'v+~IC ~1`pr 1 Y%1i nP L File ~: C'$1 '0 )f npany/Address: (1..I.,w• ~ 1...•n., l~._I (}~_ Mine Contact: GSi.....-r.~ te: C1,~ c~ Time: 11 3J Weather: ('ir,.~ (° J nments: C~_y~-4 .;p/,1 .../ ~N+~-..~:+ _ Laboratory: ~ _ Site ID.: 071S390S Zy /~} Location: SV(~,~ /L/ ~~u;~r~ ('r oe~c (/~D;~rr..n Full Ground Water/ u 1 ur ace at /Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: cM Irt i M n-r~ Time: 9';0 Sample Split: Vr5 Comments: ;10. r•R ny(l H•R Flow/Level: , 02F. fFs pH:~~lTemp. y6 EC. n10 ~1(,Q Other: Site ID.: 071R`I 0_S2'~ ~ Location: P~^~ Full Ground Water/Full Surface Water/ tial a/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: f1'1'~~< ~r+,mo~ Time: /Q;O~ Sample Split: ~c Comments: v. e~r~ r•ti ~j cc ,m~ Flow/Level: ,y°I c~S pH: 'q emp.~_EC. !1 ?.J OOther: Site ID.: 0~~4`1QSL1~ (, Location: Spv~c~, ~ry Full Ground Water/Full Surface Water/P2FFial S e/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: Oh ~cr ~MY,nP~~ Time: ~J 3i7 Sample Split: ~(?=, Comments:, r o 1tt, r•~ ~Z. EC.~ 4~6~ ^'. Flow/Level: Iq c~5 pH: 7~ ~'emp. i tiZ/I3~~D Other: II Site ID.: n7I Pal Q~ Zyb Location: SltP ~ ( ~F-~i (~P~ ~r~r ~i ~~o•-.- aN ~_s~ Full Ground 4later/£~+~1 Surfarp WaFPr/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: r\~ ', r ~ i Mrr ° ~ ~ Time: II •t1J Sample Split: .y,o~' Comments: c1~c I r,~_~ c,. Flow/Level: ~,q (~Ac, pH:>,y (~,3Temp.~_EC. i'v Site ID.: Location: Temp. EC. Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw Disposition •_ Sample Split: Flow/Level: AIN OF CUSTODY Transferred from: Transferred from: ceived at Lab by: ~34F Time: Comments: Date: M ~R >QO Other: Other: To: Time/Date: To: Time/Date: c~~y s~ ~ r~~s~~5 O O O Y R M O D Y A ~lb~gy -