HYDRO22385

• Permit No: C1981038
• IBM Index Class Name: Hydrology
• Doc Date: 5/12/1995
• Doc Name: MONITORING FACT SHEET LABORATORY SAMPLES
• Permit Index Doc Type: OTHER SURFACE WATER
• Media Type: D
• Archive: No

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MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
LABORATQRY SAMPLES
1. Site ID.:~,y,~ y ~4,,,n~,}L.I Location:
Full Ground Water/Full Surface Water(/ a
Disposition: T Cpy ,a ~(( c,~ w
Sample Split: ~ Comments:
~i~i-u~iriiiiii iii
sss
/Soil/Grab/Composite/Filterr~ed/Raw
Time: l S', Vo
Flow/Level:_~, /~ ,u pH: Temp.yR.1S~EC. ~1~Other:
2. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition:
Sample Split:
3
Comments:
Time:
~r ,
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: Comments:
Flow/Level: pH: Temp. EC, Other: '
G:--
4. Site ID.: ~ Location:
i
Full Ground 4later/Fu11.Surface Water/Partial Sample/Geo./Soil%Gnab/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•
Sample Split: Comments:
Flow/Level: pH:
Page ~ of ,
T
Time:
Temp. EC. Other:
CHAIN OF Cb~TODY
1. Transferred from: To: Time/Date:
1. Transferred from: To: Time/Date:
.y
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Received at Lab by: Date:
8934F
O O O Y R M O D Y !.
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