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<br />COLORADO DEPARTMENT OF HEALTH Water Lab No.' <br />Water Quality Control Division (From Water Qua ata hee '• <br />( Sampl a Collected by MLRD) ,:. - - ;~:? - - <br />1. Name of Company: <br />2a. Name of Mine: <br />3. Date of Contact: <br />' 5. Mine contact/titl• <br />?,J. $ox <br />6. Phone: 925- Si2i <br />7. Ip Spector/Samp er: a~;~ r'rfv <br />8. Date an ime o Samp ing: ~S;is / a~23/S3 ~ ' <br />9. Does Mine Representative wish to b& present?: yPs <br />10. If so, .list name, title,_and phone: t~,n.e as o brut <br />...Does t e Operator wish-a Samp a sp it?„ Int.ia s: <br />12: Wi 11 the Operator provide container? aPeiriW ,fie sc» 7~e a, ~,;, I4 iti al s : ~~ _ <br />13..Are there any-.special arrangements.;to meet at site. n/~ ~• <br />14. Parameters to be: Monitored: Total Suspended Solids pH - .~~ - :}: <br />Temperature Settleable Sclids ' 'Ircn ~anganese <br />Other (list): un e = - <br />15..Type of Sample:_ ra ~ Composite Descri a ocation camp a„was <br />- taken: 'l4f '{ne ,;.,~i- ~~.~'.,+r~~ ,~! :~;~:~. ;i ,-~ a .,,`.,~., <br />..~ 16. Containers: ~C.;•Plastic containers w/o acid Size: f '...-- <br />r.Plastic containers. acidified w/HN03 .- Size• ,,,, <br />.-:Other: edh~ --~~p•). S..,nphl~ - - <br />17. Name & Tit e o .Per ons Present During Sing~): .,1 ,~n, /i)i-fG <br />18. Was sample split? U <br />19. Who Received or De~ <br />Sc r <br />20. Disposition of Samp e <br />6,.~ n,.~~. 1.iP ~r ur o ''w <br />1 <br />itlname,iitie, initials <br />~~e <br />r col ection• ~4.,. - <br />Z Jas ~~/. ~1 s, ~~u <br />_r , <br />Transferred From: io: <br />Transferred From: 70: <br />Transferred From: To: <br />Transferred From: To: <br />Received at Lab by: <br />Comments: <br />'rio ~ <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />Time/Date: <br />ote: If Laboratory analysis c <br />violation of the "Water Quali <br />quality Laws, these result G <br />Signature of Sampler: <br />ENFORCEMENT MONITORING FACT. SHEET " <br />_i:;'~ <br />o.ie<:«~ 1~~~niru Co, . 2. NPDES Permit#: [D- Otb0i5t ,•~ <br />2b. MLRD Permit#: c- Ei- yzs "'~y'"='<' <br />~z~/~~1 ,3 l~ ~ 4. TimL~e of Conntact: isr:r ~~r.;~:~~.'';r- ~: <br />QUOreSS:~1•,*Q V^ ~..M !/ar~ //~~~1~~~'`'O. '': k ~~. ~.~ <br />e aoove mentionea sample inoicates a <br />Qntrol Act", or other State or Federal water <br />e used in the future for enforcement actions. <br />Doc. # 8683E-B ,~ <br />L,.-'" <br />