HYDRO24136

• Permit No: C1981044
• IBM Index Class Name: Hydrology
• Doc Date: 2/16/1993
• Doc Name: LAB ANALYSIS
• Permit Index Doc Type: DMG SAMPLING
• Media Type: D
• Archive: No

Operation• t
Company/Addre
Specialist:
Date:
C~o/m~ment s
l',ccAri / t ~.ylt
1. Site ID.:
Page ~ of L
MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
LABORATORY SAMPLES
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i4T(,JQ~, r>!J .PXJ-t. (~5 ~i'di(r (~0 31(~ ZS" Mine Contact :Tt'r/f///C/[I15 ~'t/
T'me: 1S:L Weather:
.y ~ s Laboratory:
7 ~ OO.3fIxZ r0"a3 'Location: ~Ikcw s rr+~:~e ,,~~O~u ~(iOC~
Full Ground Water/Full Surfac//e Wate artial Samples Geo./Soil/ rab Composite/Filtered aw;
Disposition: (~Q?jq~~~Z,V Time: IS'2i
Sample Sp1it:~Comments:
low/ eve l: ~i~,(~(~-'11 pH:1f.LTemp. $0,0 EC..uffa~.ttit Other:
2. ite 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:
3. Site ID.: Location:
Fu11 Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. £C. Other:
4. Site ID.: Location:
Full Ground Llater/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
5
Disposition:
Sample Split: Cortuaents:
Flow/Level: pH:_
Temp. EC. Other:
CHAIN OF CUSTODY ~+,yy
1. Transferred from: .a"//Gi~tf1U~'G~l~ To: ZIPS Time/Date: (!~; C~ Ll z~/`%~r
1. Transferred from: To: Time/Date:
Received at Lab by: Date:
Time:
8934F OOOYRMODYA