Laserfiche WebLink
T ~ <br />Page ~ of <br />~ LAND RECLAMATION DIVISION <br />MONITORING FACT SHEET <br />LABORATORY SAMPLES <br />3peration: ~,oi,,'~o ,M ~'lb NQ, \ File ik: e-~I ~~~~ <br />Company/Address: Mine Contact:(,\~ ~.r~! <br />Specialist• ~ o <br />Dater q, Tim oID W~ather: <br />Comments• (.__. 5~..11~ Cc..n ~~~.~.C_ _ R~ __. t~ Labotatorv:~ nik <br />1 <br />Site ID.:~,y~~ ~ ~4,,,,P~ Location: <br />Full Cround Water/Full Surface Wat@~\r Part~~\\ia <br />Disposition: ~~9. .aa-[cv~.\~~+-"T e T: <br />Geo./Soil/Grab/Composite/Filtered/Raw <br />~~ Time• l~ p0 <br />Sample Split: Comments: <br />Flow/Level: ~ pH: Temp.4 ~.EC. ~ 1 ~ Other: <br />2. Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: Temp. EC. Other: <br />Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />3 <br />Sample Split: <br />Flow/Level: <br />4. Site ID.: <br />Comments: <br />Temp. EC. Other: <br />Location: <br />Full Ground 4later/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: <br />5. Site ID.: <br />Temp. EC. Other: <br />Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition:_ <br />Sample Split: <br />Time: <br />Comments: <br />Flow/Level: pH: Temp. EC. <br />Other: <br />CHAIN OF CUSTODY <br />1. Transferred from: To: Time/Date: <br />1. Transferred from: To: Time/Date: <br />Received at Lab by: <br />Date: <br />8934F 0 0 0 Y R M O D Y A <br />