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DEp/ ~. ~ III IIIIIIIIIIIII III ~~ <br />Water Quality Q~ntxrol Division FROM SYATFi3 QUALITY DATA SHEET <br />~r1~Ri:E;ii:.T 1'Urrili;'i:L'<<; F;iCl' Skilii;l' <br />1 <br />3 <br />5 <br />Name of Eatity: <br />Date of Oontact <br />Person contacte <br />6. Phone No. where he can be reached: '71~ (ova -~]~( 7. cbntacten by:~~~~~ <br />8. Date of Scheduled Sampling: ~, -13 -~-7 7 <br />9. Does Representative of Entity Wish to be Present? <br />10. If so, ~a~hat is his :~r~e, titi:' ::..._ .... .: ~•ir=r?_Ljg;~_L2o,C~e~onJ _--- <br />11. Do they wish to split samples' Ye S <br />12. If so, will they provide container? ~¢S <br />13. What a,-r~r,gements have been made to meet representative and/or gain entrance to the <br />facilities: <br />14. Par..~meters tO be monitored: BOD SI1S >lded Solids D.O. pH <br />Fecal Cbliform Temperature Turbidity Chlorine Re~iual <br />oil & Grease ol~xs (list) : /}~D ~~ C~ ~ ~` <br />15. Type of sample (grab or ccaQosite, 'describe)? ~' 2~-/3 <br />r <br />16. Special containers or preservatives? L~4S G OTTL2 <br />17. Persons present during sampling (names & titles): <br />18. Was sample spli~ <br />19. Who received aa~ <br />20 <br />Disposition of sample after collection: - S e N <br />L e cis ~ e ~ <br />ra ~s ~o e c-Qn !~ cv' <br />e vim. c <br />A3~ tee. a.= I ~4 5 LP c.e~LfS <br />`TR~4oJS fde/L7'~Li `a C ADiFf 4 e aoJ <br />