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COLORADO UEPARTPIENT OF HEALTH Water Lab No. <br />Water Quality Control Division (From Water Qual~~ata heet <br />(Sample Collected by MLRD) <br />ENFORCEMENT MONITORING FACT SHEET <br />1. Name of Company: ~ ~, ' T 2. NPDES Permit#:?~_ 1 <br />2a. Name of Mine: 2b. MLRD Permit#:S' p <br />3. Date of Contact: 4. Time of Contact: ~~.n <br />- 5. Mine contact/title address: jo v1v ~~n~ - SC-_J!1i2~>;n_~,2neef <br />~- 6. Phone:/-7. ' -Z I /. Inspector/Sampler:C~t'~S~tor <br />8. Date an me of Samp ing: <br />9. Does Mine Representative wish to be present?: ~ e5 <br />10. If so, list name, title, and phone: _„ „~ <br />Il. Uoes the Operator wish a sample sp11t? h ~ Initials: / <br />- 12. Will the Operator provide container? /1,~ Initials: <br />13. Are there any special arrangements to meet at site? V~ <br />14. Parameters to be Monitored: Total Suspended Solids pH <br /> Temperature Settleable Solids Iron -Ffangane~se <br /> Other (list): '1\ u <br />15. Type of Sample: Grab CompQ ite <br />taken: OT:,\\ p;'~ Q rna~1-~rv.o _ D scribe <br />c~~tc~aree ocation sartipT was <br />p~)l~~' <br />16. Containers: Plastic containers w/o acid Size: <br />Plastic containers acidified w/HN03 Size: <br />Other: \ <br />17.(~ Name & Title o Per`s~QQ\\ns P\\rese D/u~ring Sampling: <br />Sl/(~(^~2\ :1~ ~nn~i U1U\lir~ n.. ~/~vC:/\ ~r~o '~~ n.` .,• <br />ItS: was sampleispiiu <br />19. Who Received or Denied Sp it Name,Tit e, Initia s <br />Iransterretl prom:/~~~ jhJw-•~ 10: <br />Transferred From: _ ~ ,., ;;,i /~ iJ~„ , , ,: To: <br />Transferred From: - To: <br />Transferred From: To: <br />Received at Lab by: <br />Comments: <br />,, rl~ <br />)r\~roh <br />Y\e ~\ 4 Fw.T~ cr. <br />- _ weer <br />"~~~~: <br />Time/Date:/ice/rte' i~"`"-" <br />Time/Date: , /; ~ / ~ >. its r, ,.~ <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />Note: If Laboratory ana ysis o the above 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 b^^e used in the future fort ~nforce\m1e~nt actions. <br />Signature of Sampler: ~~ 2 /.}-y~.wG /~ r9~ W ~1'~k-~ <br />Doc. # 8663E-B <br />