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~'- "~E~~~VE~-. <br />JUN 031987 <br />MINED LAND <br />C~ECLAMATION DIVISION <br />Operation• l~,t <br />Company/Address: <br />Specialist: <br />Date: =!i' T <br />Comments: ~ a <br />-~ <br /> <br />MINED LAND RECLAMATION DIVISION <br />MONITORING :FACT SHEET <br />LABORATORY SAMPLES <br />File Ik: <br />i ~~/n <br />_, <br />Weather: ~,.~/Wl.-F}P,~~- r~ <br />_.: ~ _ .,, i. ,~C ..aa ,..~.. L Laberal <br />Psge-~of y <br />r-6~'~ / <br />~/~ <br />1. Site ID.: :~7Zh7~ej14-A Location: 1~,~ /li:~n ?!;'ASS /)d_rA <br />~ J <br />Full Ground Water/Full Surface Water/Pa~rltial Sample/Geo.1/Soil/Grab/Composite/Filtere~ld~/Rav <br />Disposition: Y~ )rf : '''r~.0 ~ n.) (.)Ili ~~ ~,)l~~ n1D ~S I'7 71.P 1'11TIM ~ Time: /TJ(D <br />Sample Split: ~~ Comments: ,D/1.~,; ,~G/,n../ ~)/d•i1~n ~~ /;Ii/ 1~%<n,~~,v.iAr?' <br />Flow/Level: I~DD n•~L~,(3 sPG PN: z~Dy Temp. 71''F EC. ~,nD J Other: n//A f~' <br />2. Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Piltered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: Temp.. EC. Other: <br />3. Site ID.: Location: ~~~~~.. <br />Full Ground Water/Eu11 Surface Water/Parttair!®9o7prit/Seo~/Soil/Grab/Composite/Filtered/Bav <br />Disposition: r Time: <br />Sample Split: Comments: -- <br />Floe/Level; pH: Temp. EC. Other: <br />4. Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Rav <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/Rav <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Le-.•_1: pH: Temp. EC. Other: <br />CHAIN OF CDSTODY <br />1. Transferred from: ~~D-?/~P/ To: ~~ I/, {~ Time/Date: <br />1. Transferred from: To: Time/Date: <br />~ / <br />Received at Lab by: /~-~-~ V r'=/ ~•/ fl:= ANC Date: '/i : %•~ <br />8934F OOOYS~?[OD' <br />