HYDRO29070

• Permit No: C1982056
• IBM Index Class Name: Hydrology
• Doc Date: 9/28/1993
• Doc Name: MLRD MONITORING FACT SHEET LABORATORY SAMPLES
• Permit Index Doc Type: CORRESPONDENCE
• Media Type: D
• Archive: No

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3pera[ion: j,(,~t-~~.7t,,,~~~' ~~~ File #:
Company/Address: '
Specialist: 7
Date: Time: a Cher:
Comments: i Laborat/o7ry~:
1. Site ID.: on/a9eZ193 Location: 0~ CyZ`
Fu11 Cround Water/Full Surface Water/Partial Sample/Geo./Soil rab/
Disposition:-
Sample Split:
Flow/Level:~j,
site/Filtered/Raw ¢~
_T ime
_. Site iD.: QOZ 09Z/43 Location: VJ"lv>~S'fY9z..~ T{22,~ O'~" ~/Zk- ~'4h~U~--c
Full Ground water/Full Surface tJater/Partial Sample/Geo./Soi G a omposite /F iltere / aw ,
Disposition: L~/+n/{/V
Sample Sp1it:~Comments: G'
Flow/Level: Ne.RSfi pH:~~Temp.~
3. Site ID.: rrb3r~9Z/C/ ~ Location:
Time:
t„"'~`'°) • / hi~rer r
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil ra Composite/Filtered~t~Y~i.
Disposition:
Sample Split: I Comments: ~/1///1~(/J
Flow/Level: .2. z .~ tZv pH:~~Temp. ~p7~ EC
4, Site ID
Location:
c, .. `
act:
r:
Fu11 Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition:
Sample Split: Comments:
Flow/Level:
5. Site ID.:
-Temp. EC.
Location:
Time:
Other:
Time:
Fu 11 Cround Water/Fu 11 Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Fine red/Raw
Disposition:
Sample Split: Comments:
Fiow/Level: _ _ _ pH :_ Temp. _ EC. _ Other:
Time:
CHAIN OF CUSTODY
1. Transferred from: 2../ To: Time/Dace:
1. Transferred

Received at Lab
8934E
Comments:
from: To. ~_TiQme/Date.
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~` ~~ -- Corna~iuon of. Sample's Upon,Receipt ~~ l
Ry ACZ Laboratories, Inc:
C~MLP~ ^~~.--~ -- Temperature of Contents: °b Oe~ Y R H n D
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