HYDRO26404

• Permit No: C1981025
• IBM Index Class Name: Hydrology
• Doc Name: ENFORCEMENT MONITORING FACT SHEET
• Permit Index Doc Type: DMG SAMPLING
• Media Type: D
• Archive: No

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COLORABO .
DEPARTMENT OF
HEALTH
Water Lab No. Q ~`Z~}
Water-Qu ality Control Division (From Water Qua Data heet
(Sample Collected by MLRD)
ENFORCEMENT MONITORING .FACT SHEET I ~

1. Name of Company: A.1 i NLr ~- 2. NPDES Permit#: --
2a. Name of Mine: N j~ ~~-,,~~?k, ( (;~, y 2b. MLRD Permit#: _ , I . i _,,-
3. Date of Contact: ,,~i;,,14 ': 4. Time of Contact:
5. Mine contact/title a ress':
6. Phone: 7. Inspector/Sampler: ~, », ,, Lq ; i %
8. Date an ime o Samp ing: i( ,-a ~ ., th:. /-/ °> ~ '
9. Does Mine Representative wish to be prese t?:
10. If so, list name, title, and phone:
. Does the Operator wish a sample sp it? Initials:
12. Will the Operator provide container? Initials:
13. Are there any special arrangements to meet at site?
14. Parameters to be Monitored: Total Suspended Solids pH
Temperature Settleable Solids Iron -FTanganese
Other (list):
15. Type, of Sample: Grab '/ Composite _ Describe ocation Samp a was
taken: ~.YYIt.YCA(:rl: ~ n~4'~u7~~i~`i. fti~°.~i,:,,:.,ti ~~Ikrl~-]

Time/Date:
Time/Date:
Time/Date:
Time/Date:
Doc. # 8683E-B
Other
17. Name
ainers: ~ Plastic containers w/o acitl -/ Size:
`~ Plastic containers acidified w/HN03 l .j Size:
ng:
e or rersons
18. Was sample split? U,~„
1g. Who Received or Denied Sp it ame,Tit e, Initia s
20. Disposition of sample after colhection:- '_
Transferred From: /./e~CLI ; ti~,; I~, io:
Transferred From: ~J To:
Transferred From: To:
Transferred'From:-~ r To:
Received at Lab by:
Comments:
'.u

violation of the "Water Quality Control Act", or other State or Federal water
quality Laws, these resu-l/ts may be used in the future for enforcement actions.
Signature of Sampler: ^/,~~~~ _) ~- /-%~-Z%~ "/