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~s~ <br />COLORADO DEPARTMENT OF HEALTH `~~~ op 1996 Water. Lab No. Q s7 <br />(SampleuCollectedtbylMLRD)Sion OiM~~eig~sBGep/o9~From Water Qua ata h t <br />ENFORCEMENT MONITORING FACT SHEET <br />1. Name of Company: _ <br />2a. Name of Mine: <br />3. Date of Contact: <br />5. Mine contact/title <br />d. rnone: ~ / /y"31f00 <br />8. Date anc ime o ~am~ing: <br />9. Does Mine Representative w <br />10. If so, list name, title, <br />2. NPDES Permit#: G'D- <br />2b. MLRD Permit#: C-f <br />4,. Time of Contact: /; <br />. Inspector/Sampler: <br />ish to be <br />and phone: <br />ii. Does the Operator wish a sample split"? 5 Initials: <br />12. Will tFie Operator provide container? Initials: <br />13. Are there any special arrangements to meet at site? o <br />14. Parameters to be Monitored: Total Suspended Solids ~ pH <br />Temperature ~_ Settleable Solids ( Iron anganese <br />Other (list): <br />15. Type oi' Sample: Gra ~_ Composite _ Describe ocation samp a was <br />taken• <br />16. Containers: _ Plastic containers w/o acid Size: <br />_ Plastic containers acidified w/HN03 Size: <br />Other: <br />17. Name & Tit Q o Per~sops Presgntipurir}g $amp ing: <br />Who Received or <br /> <br />Transferred <br />Transferred From: <br />From: To: <br />To: Time Date: - "3-yC /x!04 ~~ <br />Time/Date: <br />Transferred From: To: Time/Date: <br />Transferred From: To: Time/Date: <br />Received at Lab by: Time/Date: <br />Comments• <br />re>c 1 ~ rf- ~- ~- 4G, ~ 1 w <br /> <br />Note: I a oratory ana ysis o tea ove mentione samp a in icates a <br />violation of the "Water Quality Control Act", or other State or Federal water <br />quality Laws, these results a be s din he future for e~/nforcement actions. <br />Signature of Sampler: ~(.cM--, z"~/"/~ <br />Doc. # 8683E-B <br />20. D position of sample after collection: <br />