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<br />COLORADO DEPARTMENT OF HEALTH
<br />Water Quality Control Division
<br />(Sample Collected by MLRD)
<br />Water Lab No. 3 C ,
<br />(From Water Qua ata heet
<br />ENFORCEMENT MONITORING FACT SHE
<br />1. Name of Company: ~ .~•. ,. ~ ..;i r.i.,,..>, •-,-..:,~.,:,, 2. NPDES Permit#: ea- ,,c;~r.;v
<br />2a. Name of Mine: ~u~-.~ .,~,,.,.:vt,'~:; ~ 2b. MLRD Permit#: ~, ;
<br />3. Date of Contact: ~ ~~i ; 5 4. Time of Contact:
<br />5. Mine contact/title a ress: ~ ..~ ~. .:-:::. ~ ~.
<br />6. Phone: - «, r ! i 7. Inspector/Sampler: ;i,r ~,~, ,,, ~ i.i., .;: ,-~-
<br />8. Date an ime o Samp ing: - ;- 1:; t.;<,
<br />9. Does Mine Representative wish to be present?: ,.,
<br />10. If so, list name, title, and phone:
<br />11. Does the Operator wish a sample split? ,-.ti, Initials:
<br />12. Will the Operator provide container? Initials:
<br />13. Are there any special arrangements to meet at site? ,, :,
<br />14. Parameters to be Monitored: Total Suspended Solids pH
<br />Temperature Settleable Solids Iron Manganese
<br />Other (list): ,, •± :. ,-
<br />15. Type of Sample: Grab ~ Composite ` Describe ocation sample was
<br />taken:
<br />16. Containers: _ Plastic containers w/o acid Size:
<br />_ Plastic containers acidified w/HN03 Size:
<br />Other: -- ; ~!< ;
<br />17. Name & Title of Persons Present During Sampling: , ,.., ,. ;. ., i ,:,.,,,,; ,: ;.
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<br />18. Was samp]e'split?'
<br />1g.:Who Received or Denied Sp it Name,Tit e, Initials
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<br />20. Disposition of sample after collection:
<br />Transferred From: - ,, ,,,„~j,~ To: ~ Time/Date: r..; :~'i% ;, ;
<br />Transferred From: ~-~ To: Time/Date:
<br />Transferred From: To: Time/Date:
<br />Transferred From: To: Time/Date:
<br />Received at Lab by: ~, ~~ ; •, -. ...-___ Time/Date• ~ ~ _~ -~- ~ ir,; ,
<br />Comments•
<br />Note: Laboratory ana ys~s o t e a ove mentioned 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.
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<br />Signature of Sampler: %1,:~1 L ~i.~y ~ -
<br />Doc. # 8683E-B
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