HYDRO30754

• Permit No: C1981047
• IBM Index Class Name: Hydrology
• Doc Date: 5/25/1993
• Doc Name: SAMPLE NUMBER 931473 COLO DEPT OF HEALTH
• Permit Index Doc Type: DMG SAMPLING
• Media Type: D
• Archive: No

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JUN 12 1985
MINED LAND MINED LAND RECLAMATION DIVISION
N N HE
RECLAMATION DIVISION
Operation: , File #: ~, -[3~-(-1-8 ~
Company/Address: 1
Specialist: r
Date: ~„-~-g im 11' p qM, Bather: SLLnrw ~ir.rm
General Location: n.la„o t-l~.bborr{ Grcc~
General Commments:
II
1.
Laborat.or Sam les
Si e~T~: rna-E ocation: m;no wa' ~Q~ d~x~w.tat
Lab: 6GL Parameters: Fkll -,~.r~nLC ii~0 Descrip on: r.l~,r
Dispositicmi ;cc uc,d:C;r IGLLrL ~r~ cool Grab/Composite: nrah
Sample Split: r~ ents: - ~-
Flow/Level: - pH: - Temp. - EC. - Other: -
Site ID.:g~m3 485LOCa~tOn: ~' •I
Lab: BGL Parameters:-F,~I~ aw os e_ ~escription:~ irdr
Disposition: ;L.cd/nc~d;~(ed oiwccri ~ h coolcrGrab/Compose e: Drab
-
Sample Split:~Com1n nts: - ~
Flow/Level: - pH: _ Temp. - - t er:
Site ID. ~fi4-b+~ocation: ~~L~Yc ~o„ti h h ~,crdra:n ~,~r°Ih e„~
Lab: 8G L_ Parameters: escrip ion:
Disposition:f;lttrec~_;~crl~e.:d~ :Lfl_ :n eee~er Grab/Composite: G~-
Sample Split •. ~d Comments:
Flow/Level: pH: - Temp. - EC. - Other:
4. Site ID.: Location:
Lab: Parameters: Description:
Dispos tie on: Grab/Composite:
Sample Split: Comments:
Flow/Level: p Ti Temp. EC. Other:
5. Site ID.: Location:
Lab: Para meters: escription:
Disposition: Grab/Composite:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
C ooinr ~ e C~ l ~ ~~ d
CHAIN OF CUSTOD Y
1. Transferred from: To: Time/Date:
1. Transferred from: To: Time/Date:
1. Transferred from: To: Time/Date:
1. Transferred from: To: Time/Date:
Received at Lab by: ,,,,,~,.~ ~ 9-11~ - Date: ~licz (Sr5

85 Doc. 8934E