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<br />COLORADO DEPARTMENT OF HEALTH Water Lab No. Q~P b ~ OZ <br />Water Quality Control Division (From Water Qua ata heet <br />(Sample Collected by MLRD) <br />ENFORCEMENT MONITORING FACT SHEET <br />1. Name of Com an ~ ~~~ 2. NPDES Permit#: <br />P Y: <br />2a. Name of Mine: , 2b. MLRD Permit#: ('~~ <br />3. Date of Contact: 4. Time of Contact: ~: ~U T <br />5. Mine_ contact/title a re s: KIm Y.v1U 0~~ - .~i~31 ~C(~kLC?t-f 13~_ <br />ns <br />8. Date and Time of Sampling: ~S <br />9. Does Mine Representative wish to be p <br />10. If so, list name, title, and phone: <br />er <br />II. uoes the uperator wisp a sample spiitt ~/~~ initials: <br />12. Will the Operator provide container? ~U Initials: <br />13. Are there any special arrangements to meet at site? u <br />14. Parameters to be Monitored: Total Suspended Solids pH <br /> Temperature Settleable Solids / Iron / anganese <br /> Other (list): <br />15. Type of Sample: Gra omposite <br />escri a ocation camp a was <br /> _ <br />taken• <br /> <br />16. Containers: Plastic containers w/o acid Size: <br /> _~ Plastic containers acidi led w/HN03 <br />Other: ~OIU CiCan Size: <br />17. Name & Tit e o Persons Present During Samp ing: <br />e <br />te <br />p <br />18. Was <br />a p <br />split? <br />s <br />19. Who Received or Denied Sp it Name, it e, Initia s <br />20. Disposition of sample after co lection: <br />Iransferred From: ~)VY/L.'1 lo: <br />Transferred From: TTo: <br />Transferred From: To: <br />Transferred From: To: <br />Received at Lab by• <br />Comments: ~~rryn,~ll„ .1,~.nm ~r~il~r <br />Signature of Sampler: <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />~~~9~ <br />Doc. # 8683E-B <br />Note: I La oratory ana ysis o the 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 results may be used in the future for enforcement actions. <br />