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<br />OJUIiADO DEPAKIMNNr dF HEALTH <br />Water Quality Control Division <br />F'f~JM WQOALITY DATA SHEET <br />z[y~rURt;Er.:~.T ?.+C)ir~1C)i{Ii~~~ I~ACI' SiiL•;iiC <br />1. Name of Ibtity: ~ Au ~~,u < Pti' a \e.C ~ 2 • Permit ~ ~ H' o n~) I ~- <br />3. Date of Oontact: 4. Time of Qbntact: ~e;_ta <br />5. Person contacted (name & title) : r`S IZ a L 1 e 2~' S B ~-= <br />6. Phone No . where he can be reached : 7. (bntact by ~ . ~ Rn e t n ~ ~ ~ ~ ~ <br />8. Date of Scheduled Sampling: 3 - I o-q 7 <br />9. Does Representative of Entity Wish to be Present? <br />10. If so, n~hat is his tiamc, titi: ....: , ... ,. rcir,r^ <br />11. Ib they wish to split samples? Ye S <br />12. If ~, will they provide container? Ye S <br />7.3. What arranRenents have been made to meet representative and/or ga,n entrance to the <br />facilities: <br />14. Parameters to be monitored: 13~ Suspended Solids D.qq pH <br />Fecal Cbliform Te~ature Turbidity Q~lorine E~esidual <br />Oil & (pease 01>iHRS {list): Toifi~- ~ t~Sq C ~n[llJ~ <br />15. Type of sample (grab or ccaiposite, 'describe)? ~' n /~ Soi r_ S,~r1rtPLC <br />16. Special containers or preservatives? Rio <br />17, <br />18. Was sample spli <br />19. Who neoeived or <br />?A. <br />RH7rIARKR <br />No <br />