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• • ~ 2 <br />' Page of <br />MINED LAND RECLAMATION DIVISION <br />MONITORING FACT SHEET <br />A~ LABOR1A/TORY SAMPLES <br />Operation: 'Y ``r ~ one, Z ~C~Ly~,ry n/F- File dk: ~-55~-~7/ <br />Company/Address: • 27 ~" ~ ine Contact: <br />Specialist: „ ow <br />Date: A~2r~gk ime: //,;Lp Weather: ~.~ 1.~.,.rr., <br />Comments: Laboratory: <br />1. Site ID.: ®I! o~rBBoB~s A Location: ~y,•}fr,.~ $~j1Jps f <br />Full Ground Water/ 1 Sur ace a e Partia /$ample/Geo./Soil <br />Disposition: ~(~„~ ~mVV1eO{, ~1r~ g~~/~ <br />2 <br />ite/Filtered/Raw <br />Time: /y,3o _ <br />Sample Sp lit:_Yrs Comments: SP~•il '~ B(le-~rn{s~ <br />Flow/Level: ~~`~~ ~~1 H: Tem <br />~- 2•q3 P ~6•~ P• 22~C EC. Z$1~ Othe\\r: <br />site ID.: p71B$O$25~, Location: f}rr~ ti/)D ~/ (7'odso~~ J ~fnnhrP ,,.,,OOSi~p <br />~ ~ _~ <br />Full Ground Water/F--u~~ll Surface Water/Partial Sample/Soil/Grab/Composite/Filtered/Raw <br />Disposition: (~umL105iTP ~ 1'( C,..n.OICS Time: l~:On <br />Sample Split: p/p Comments: Zbp50~' Grog <br />Flow/Level: pH: Temp. EC._ <br />3. Site ID.: d71B4sOSc'zSG Location: .1 9 Jp <br />Full Ground Water/Full Surface Water/Partial Sample/Geo <br />Disposition• ~'~ A Ir <br />Sample Split: /gyp Comments: 0 0~ ~ Nq 4i <br />Time: <br />Flow/Level: pH: Temp. EC. Other: <br />4. Site ID.: X71 gg0~•ZS n Location:-~ 9IIQ #~3 ~To~ ) ~SD7raM ~i~t <br />Full Ground Plater/Full Surface Water/Partial Sample /Geo./Grab/Composite/Filtered/Raw <br />Disposition: 05 $q <br />Sample Split: ~rp Comments: <br />Flow/Level: <br />5 <br />.i <br />Temp. EC. <br />Other: <br />_, ~ <br />/Composite/Fil[efed/Raw <br />Time: /Oi3 O <br />Other: <br />Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: <br />~FIAIN OF Cl]S TODY <br />Temp. EC. <br />Other: <br />1. Transferred from: To: Time/Date: <br />1. Transferred from: To: Time/Date: <br />'"' I r- <br />Received at Lab ba: ~ ~j1~1'J~G~~~~ ~ ~ Date :'~~~ ~_;i; •ti' ;' ~ fr'". <br />~. <br />._ ,-~ <br />3934F ~ O O O Y R "1 O D Y A <br />