HYDRO31027

• Permit No: C1981023
• IBM Index Class Name: Hydrology
• Doc Date: 7/9/1986
• Doc Name: MLRD MONITORING FACT SHEET LABORATORY SAMPLES
• Permit Index Doc Type: OTHER GROUND WATER
• Media Type: D
• Archive: No

,~~ ~ .~
~~ ~ ~ :w ~-~ `: III IIIIIIIIIIIII III
MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
`• LABORATORY SAMPLES
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Page ~ of ~_
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Operational//ryNCq ~~%c+~ ~o?/ C~'d File ~: C- S~/-O~
Company/Address: mfr 1 r,,,. 7r ~ s C / s cs Mine
Specialiat:_~~' ~~.,,~.~-2
Date:' ~ 4 9[ Time:_ [U A.-s Weather: C /~ r_ /?'-j
Cammenta:S„„, /s wr. // . /3 n. /o /J 7-T-Y!/TR .t Laboratory: ~oitr,
[y~ ,G+ tin n~
1. Site ID.: r/ilr~ S / a fr6 Location: S/~n~ /s r,. c // , = n s T r- // A /~~/+
- '~
_Full Ground Wate ull Surface Water/Partial Sample/Geo./Soil/Grab/Compoaite_ filter Raw
Disposition: POr Sc77vaT7 ~[ [~ /~ ~ S~-nom yv /wa 7. // rt6 Time: ~./n
Sample Split:~Commenta: ~.o lonM.vr 517.+,~/~- O. ~rcr si.O~p/3ro~,voo
Flow/Level: -~,1,/~ pH:~_Temp. /7L EC. 97S ~.yLoS Other: $OZ 6rsd//
2. Situ ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Pilfered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
3. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
4. Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/filtered/Rav
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
5. Site ID.: Location:
;.,
~:~. .
FuI'1''Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
-'Sample Split: Comments:
Flow/Level: oH: Temp. EC. Other:
CHAIN OF CUSTODY
1. Transferred from: S
1. Transferred from:
To: Time/Date: ~ ~~ V
To: Time/Date:
Received at Lab by: Date:
8934F

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