REP24773

• Permit No: C1981038
• IBM Index Class Name: Report
• Doc Date: 5/4/1989
• Doc Name: MINED LAND RECLAMATION DIVISION MONITORING FACT SHEET LABORATORY SAMPLES
• Permit Index Doc Type: Waste Pile/Fill Report
• Media Type: D
• Archive: No

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'•' MINED LAND RECLAMATION DIVISION
"" ~ MONITORING FACT SHEET
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LABORATORY SAMPLES
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130 weather:
atory:
Site ID.: ~ ~~~~~ Z8 ~ Location:S ~ ~
=u11 Ground Water/FulloSurface Wa(~te1r'/Partial Sampler
)isposition: ~~ U SV\~VP~N4~ CoMQoSr~°.C~
Sample Split: ~n Comments: Mp'lfflcy, ~(1'~-(q
?low/Level: pH: Temp. EC.
Site ID.: Location:
P.
Soil/Grab/Composite/Filtered/Raw
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ZAP ~~<< ~,,..
Other. i
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:

Sample Split: Comments:
glow/Level: pH: Temp. EC. Other:
Site ID.: Location:
'ull Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
~isposi[ion: Time:

sample Split: Comments:
'low/Level: pH: Temp. EC. Other:
Site ID.: Location:
~ull Ground Plater/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
Site ID.: Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
AIN OF CUSTODY
Transferred from: To: Time/Date:
Transferred from: To: Time/Date:
=eived at Lab by: -~~ Date:j~y~ G ~~~CJ
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