_GENERAL DOCUMENTS - C1981017 ‎(251)‎

• Permit No: C1981017
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Name: Bid Documents ‎(IMP)‎ 1993 Correspondence
• Permit Index Doc Type: General Correspondence
• Media Type: D
• Archive: No

_s SFP 30 '93 10:56AM DI':/MINERALS&GEOLOGY F.4/4
- Page of
MINED LAND RECLAMATION DIVISION
MONITORING FACT SKEET
LABORATORY SAMPLES
)peration- 2 ..\ Pile �: /1 -
l0 �'' '• 1
Company/Address: Mine Contact:
Specialist: -r • 4: AN .
Date: i i 1, ; Time: LA , Q ,,.A Weather: t • \ •
Comments: c~ _ �• �1 � • -.. ,,1 Laboratory:
1. Site ID-: Location! I
Full Ground Water ull Surface Wat - Partial Sample/Geo./Soil/Grab+ Composite�k'ilterediji;N;
Disposition: F" , '1 .�, . ' �.• (� ",�„ �- . �-'�" ~: w
Time:
Sample Split:-,d . = Comments
Flow/Level:_� UQ' S` ,� pA:'1 !'` Temp:�'• EC. Other:
2. Site ID. :Q"4ir°"fit"".. � ation r"
Full Ground Water/Full Surface Water/Partial, Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments :
Flow/Level: pli: 'Temp. EC. Other:
3. Site ID. : Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments;-
Flow/Level: pF{: Temp. EC. Other:
4. Site ID. : Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
F?ow/Level: pH: Temp. EC. Other:
5. Site 1D. : Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Cor.•-polite/Filtered/Raw
Disposition: Time:
Sample Split: Comments :
Flow/Level: pH. Temp. EC. Otfher: 4 -
J
CHAIN OF CUSTODY
Transferred from: TO: Time/Date:
1. Transferred from: To: Time/Date:
Received at Lab by: Date:
8934F 000YR40D 'I