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~ Page ~ of / <br />MINED LAND RECLAMATION D,~V-~~SION <br />MONITORING FAG,.. ~ ^'1~` <br />LABORATORY S' ^~ <br />Operation: bZO~}ASl~E~GRrY~EO /1(~n/'ts File dk: C`~/-O~ / <br />Company/Address: ~ n (~ok /`f6 ~ Pe~/~____Ce'y~ Co S/S 2(. Mine Contact:~1 [/-/Kt~ , <br />Specialist: Sip•,,p ~(~ ` <br />Date:/~~2/ 2 Time; ~2!Oa Weather: P/~TG~( CLp.~p~( ,wfl2."'1 <br />Comments: r0 'CIF`( QU!}L(T7~ M WE D/ScN~4RLF 70 Laboratory:Comw~eK~od T2z ~v <br />~DU r2tYER , ~e ~r~ ~~ <br />1. Site ID.: (7~ ~ Location: CAJyLEU ~ (NE /~ ~S C///T~ "`C_. <br />Full Ground Water~Full Surface Water Partial Sample/Geo./Soil/Grab/Composite/Filtere Raw <br />Disposition: ~~.D ..n L TC7 ~- T~inme: ~ Z ~yC~ mot, <br />Sample Split: ~C/ Comments: F}Q7zY CLOUD /Pt~ ,~/SC~jQ~'6~ ~77~C~i <br />Flow/Level: +a0 cjct,~-~µ~~l pH: 8,57 Temp. ~~nG EC. Other: 1\ ~~ ~ /~~ <br />2. Site ID.: O~` ~~~(Xj) Location: rcO~I~S~O[-~ ~//~~ WISC-Tiff~~ <br />Full Ground Wate Full Surface W Partial Sample/Geo./Soil/Grab/Composite/Filtered aw <br />Disposition :_ $'eyrE Time: /i D ~- ~M <br />Sample Split: ~(~ Comments: P/I(2TC.YG[yv~~y ~ SAMpC~ DlIGjFAQ.eED Fy2o~M t1f~K <br />Flow/Level: i' 3'S ~Q,~~n.ir~ pH:g.~{ Temp. /Z°~ EC. Other: <br />3. 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 />4. Site ID.: 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: pH: Temp. EC. Other: <br />5. 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 />CHAIN OF CUSTODY n'- -/ ~/~ <br />1. Transferred from:.~.¢„~Q ~0.~S.~v To: //,..,., Time/Date: rf':/S~ /-e-e22-9Z 1 <br />1. Transferred from: To: Time/Date: ' <br />Received at Lab by: <br />Date: <br />8934F ' <br />O O O Y R M O D Y A <br />oo~l 9a loalR <br />.,. mt 9~toa.1 ~•: ~~ <br />