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- ~ -- - <br />.- <br />COLORADO DEPARTMENT OF HEALTH <br />Water Quality Control Division <br />(Sample Collected by MLRD) °~ <br />~!~'.. <br />Water Lab No. <br />(From Water Qua ata heet <br />ENFORCEMENT MONITORING FACT SHEET <br />1. .~. 2. NPDES <br />Name of Company: ,,,-_. ~ .,~,~,,U Permit#:~(~-<ti_,'t~~ <br />~5 <br />2a. ~ <br />Name of Mine: (~,,,,;n MMn t! 1 2b. MLRD ~ <br />Permit#: C, ~,_„~x <br />3. Date of Contact: ~ ' r u -.. S ~ 4. Time of Contact:T~ ,,,,, ~_ <br />5. Mine contact/title a ress: ~,,e i (~„", U, (~•,~ Q aa~3~ _ <br />6. Phone: 7. Inspector/Samp er: <br />8. Date an ime o Samp ing: z; /~~ /q~ 110 <br />9. Does Mine Representative wises present?: rev <br />10. If so, list name, title, and phone: <br />. Does t e Aerator wish a sample sp it? ~~~ ~ Initials: <br />12. Will the Operator provide container? ~ a ;~ Initials: <br />13. Are there any special arrangements to meet at sit ~ o <br />14. Parameters to be Monitored: Total Suspended Solids pH <br />~ <br /> Temperature Settleable Solids ~~ Iron angane~e <br />~~ <br /> _ <br />Other (list): _ <br />15. De tribe <br />Type of Sample: Gra J~ Composite ocation Samp a was <br /> _ <br />taken: nst-~ .Q. C`.-n~~.~ A.n.,~..• ~qr.1,,. P~r~ ~ p r r, ~,~ ~ ~..G o,~_ <br /> <br />16. Containers: v- Plastic containers w/o acid Size: 'i r <br /> `Plastic containers acidified w/HN03 Size: <br /> Other: <br />17. t During S <br />Name & Tit <br />of Persons Presen <br />mpling: <br />e <br /> ~ <br />`` <br />t <br />C <br />18. Was sample split. ~ <br />19. Who Received or Denied Sp it Name, it e, Initia s <br /> ._ <br />M ~ nw <br />~ <br />20. ~ <br />ample after co lecti <br />ition o <br />ispo <br /> n <br />S c ~ `~ <br />i ransrerreo rrom: ~;,,,, ~ Al ,~ ~ ,_ i o: <br />Transferred From: ~ To: <br />Transferred From: To: <br />Transferred From: To: <br />Received at Lab by: <br />Comments: <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />Note: Laboratory ana ysis o t e above mentione Samp a in icates a <br />violation of the "Water Quality Control Act", or other State or Federal water <br />quality Laws, these re~ull~s~may be dtsed ^~n the future for enforcement actions. <br />Signature of Sampler: <br />~!I' <br />Doc. # 8683E-B <br />