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2009-07-07_INSPECTION - M1994117
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2009-07-07_INSPECTION - M1994117
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Entry Properties
Last modified
8/24/2016 3:48:32 PM
Creation date
7/17/2009 10:44:44 AM
Metadata
Fields
Template:
DRMS Permit Index
Permit No
M1994117
IBM Index Class Name
INSPECTION
Doc Date
7/7/2009
Doc Name
Chain of Custody for Tailing Samples
From
EPA
To
DRMS
Inspection Date
6/12/2009
Email Name
ACS
Media Type
D
Archive
No
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11 <br />?q <br />U. S. ENVIRONMENTAL PROTECTION AGENCY <br />1'I..,.., .,f ¦ llC.+nfIX7 <br />Region 8 Laboratory <br />16194 West 45th Drive <br />Golden, CO 80403-1790 <br />LSR NO./PROJECT NAME ,:r. I i?Y! , ?Yt ( •• ANALYSIS v c COMMENTS <br />•.-. ? ? n <br /> e <br />s <br /> <br />SAMPLER(S) NAME (PRINT AND SIGN) O EPA TAG <br /> <br />i f ?? Y7 ??/ irt'tJ iIL J1", ( NUMBER <br /> <br />STATION SAMPLE ID DATE TIME y <br />NO REMARKS <br /> <br /> <br /> <br /> n O ? 'O <br /> <br /> <br /> o <br />rt CD Z 9 <br /> CD a <br /> ? <br />a <br /> <br /> n? <br /> on <br />o <br /> o <br /> <br /> <br /> O ? <br /> I <br />O ? <br /> <br /> <br /> O <br /> <br /> <br /> <br /> I i <br />Uq O. <br />CD <br /> <br /> <br /> cD <br /> z <br />0 <br /> <br /> t <br /> <br /> <br />Relinquished By: . 0? xv J(= ate/TimerT Received B Date/Time l <br />W Received By: Date/Time <br /> <br /> <br />s <br />Relinquished By: Date/Time Received By: Date/Time Received By: Date/Time <br />Remarks: <br />Split Samples: <br /> 23 Accepted ® Declined Signature <br />PRESERVATIVES <br />1 - Nitric (HNO,) 3 -Sodium Hydroxide (NaOH) 5 -Sodium Thiosulfate (Na,S,03) 7 -Ice Only <br />2 - Sulfuric (H,SO4) 4 -Hydrochloric (HCI) 6 - Sodium Sulfite (Na,SO,) 8 - Other <br />MATRIX <br />1 -Ground Water (GW) 2 - Surface Water (SW) 3 - Drinking Water (DW) 4 - Wastewater (WW) <br />5 - Soil (S) 6 - Sediment (Sed) 7 - Other , .? 5 t f 1 yt -U.S. GPO: 2005-774-224/25008
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