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' •, • • Page ~ of 2. MINED LAND RECLAMATION DIVISION MONITORING FACT SHEET LABORATORY SAMPLES G Operation: /If~~ ~ Itill~ 2 EL~~y+~ntn a/~ File ~: ~ '~ b~- ~~' Company/Address: q Cvf~~ C C Mine Contact: ,rh Specialist: wry- Date: Ti e: : ,3J Weather: r,,,iwi Comments: Laboratory: 1. Site ID.: (~7~ ~~/6ZS E Location: /TY~N ~~ip ~ y~ac/lv/.(rn /snu~~) ~~,h, I~n~ ,~^ ~~ Full Ground Water/Full Surface Water//1Partial Sample/Soil/Grab/Composite/Filtered/Raw Disposition:_CWn~1d51T~ ~ SG~+•I/I PJr Time: /~:IJV Sam le S lit: ~ ~r ~f { /` p p /~0 Comments: (//e/Y//o~tN C7f~L ryn titi ~i L: ~ Y 2 Flow/Level: pH: Temp. EC. Other: I Site ID.: 071 84soKzsF Location: ~Gg 5JlO ~S ~OVY~~S~ n'1i01 ~~N Full Ground Water/Full Surface Water/Partial Sampl eo /Soil/Grab/Composite/Filtered/Raw Disposition: C~wNOoS~~e ~ Sa,,.,QI P5 Time: Sample Split: /Yp Comments: Q/e,/~s~M G~OGY~~rYI AN~~y515 Flow/Level: pH: Temp. EC. Ol1ther: 3. Site ID.: p)~ $'~ ~~25 (j Location: ~„ `~'~J ~ D~/G/VV~o~rn~~Ar~/ TO~irP T Full Ground Water/Full Surface Water/Partial Sample/Geo. of Grab/Composite/Filtered/Raw Disposition: (~P~Q~P ~ $'a,~,P~PS f Time: //~ 3~ 4 Sample Split: ~ f~~Comments: 0/2ibCrG~! ~0~ „ q Flow/Level: pH: Temp. EC. Other: Site ID.: Location: Full Ground 4later/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: Time: Sample Split: Comments: Flow/Level: pH: Temp. EC. Other: 5. Site ID.: Location: Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw Disposition: Sample Split: Comments: Flow/Level: pH: Temp. EC. Other: C;I AIN OF CUSTODY 1. Transferred from: To: Time/Date: 1. Transferred from: To: Time/Date: n: 2eceived at Lab by: ~ ~t~/V~.~GL~' ~ ~ ~ ~~~ ~-D-~-e'_ ~/, ~a (-C ~Q q ~~~ 5CJ 3934F __ 0 0 O Y R M O D Y A