HYDRO20155

• Permit No: C1981025
• IBM Index Class Name: Hydrology
• Doc Date: 9/7/1988
• Doc Name: WATER ANALYSIS REPORT
• Permit Index Doc Type: DMG SAMPLING
• Media Type: D
• Archive: No

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• • Page ~ of I
MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
LABORATORY SAMPLES
oeration:~
ompany/Address:
peciali t:
ate: S( j ~ T
omment '
Site ID.: ~..2 S ~.~~C'
Full Ground Water
Disposition: /[i
s ti iY_c'L-~ File ~k: ~~ ~ (- ~'
.~: Mine Contac[: '~~~,,.Sj~.~~c,---~
Wea
Sample Split: ~~~~ Comments:
Flow/Level: ~3 l~ r~ ~~ n~ pH: Temp. EC. Other:
Site ID.: Location:
Full Ground ldater/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split:
Comments:
Flow/Level: pH: Temp. EC. Other:
Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split:
Flow/Level:
Site ID.:
Comments:
Temp. EC. Other
Location:
a[ory:
anon: ,~v w! l~ 1Sr ~ni~f{' ~' •iY ~Fr~;~.-Q
Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Time: ~' ~ `f 5
Full Ground 4later/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Spli[: Comments:
Flow/Level: pH: Temp. EC. Other:
~. Site ID.: Location:
Full Ground Water/Full Surface Wa[er/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition:
Sample Split: Comments:
Flow/Level: pH:
Temp
~f1AIN OF CUSTODY
1. Transferred from: To:
1. Transferred from: To:
received at Lab by:
Time:
EC. Other:
Time/Date:
Time/Date:
Date:
3934F 0 0 0 Y R M O D Y A