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<br />OOILRADO DITAIt1M!'Nr OF HF11L7H <br />Water Quality Q~ntrol Division <br />LAB..NGA~i: <br />FROM {YA i QUALITY DATA SR]~P <br />cZy*cUR(:Ea::.~T iYkrIlL`1tL'~C; I'AC1' SHLi'1' <br />1. <br />3. <br />5. <br />Name of Eatity:_ <br />Date of intact: <br />Perm contacted <br />permit ~!: ~-g8 lea <br />Time of +(bntact: oY3O <br />6. Phone No. where he can be reached: 7l g-G~7~ 4J~t~ 7. Cbntact~ by: ~ IA~i~S <br />8. Date of Scheduled Sampling: - <br />9. Does Representative of Fntitp l4ish to be Present? ,t~. 1' <br />10. If so, uk~at is his name, titI~ .... :.. -. ,: _°lr;r^__ ~~/.~y_~Q~~p~ i~i~r <br />il. Do they wish to split samples? `{~ S _ _~ <br />12. If so, mill they provide container? <br />13. What arrangenents have been made to reset rearesentative and/or in entrance to <br />facilities: ~ <br />14. Parameters to be monitored: BOD Suspended Solids D.~. pH <br />Fecal Qolifosm Temperature T~sbidity Chlorine ideal. <br />Oil & Gnea,Se l7ffiIiS (list): ~~g2.~GYaNf~y L~AA C fFo 57u~ <br />15. Type of sample (grab or coaQosite,'describe)? S 1L <br />-id 111~24f77~L~ 'L~evr~Q.si (~12er4 7b~trG ~S"~,.~~_ ~ ~#2}~ <br />16. Special containers or preservatives? L C~ <br />17. Persons present during sampling (names & titles): <br />~A,R 3 /2.Of~ P1l2'!`~b7. ~ M { ttirP 1'F,Q/~St}C-~~2 ~, <br />18. Was sample spli <br />19. Who received or <br />20. <br />' - <br />' - <br />I ~: <br />SQ-r~.~ <br />~~ <br />is-,.~~ <br />Mote: <br />.~c <br />Quality Control Act." these results may be used. in the future <br />r~enforcement actions. <br />