_ENFORCEMENT - C1981017 ‎(5)‎

• Permit No: C1981017
• IBM Index Class Name: Enforcement
• Doc Name: Bid Documents ‎(IMP)‎ TDN X-90-02-370-001- TV2
• Media Type: D
• Archive: No

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MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
t� LABORATORY SAMPLES
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Operation: Coo/ clS/h File #: 17
Company/Address: M,d (,Dn{ r-lLeaf- go-50.orces Mine Contact:
Specialist: Lorry R� �n
Dater 10l(k/go Time: (;.b PM Weather: ejeer
Comments: Laboratory:
1. Site ID. : d 17 Q0 (Q 1 gi Location: /VFPFS J?i*Sf&Ea,& �, OP6
Full Ground' Water/Full Surface Water �artialle/Geo./Soil/Grab/Composite/Filtered'/Raw
Disposition: Time:
Sample Split: 5 Comments: Lyti4 1�--w7jhootefo* tld,4 4et�js ihrf►arS� ,
Flow/Level: pH: Temp. EC. Other:
2. Site ID. : 0171?010 (k'Z Location: Fdov 0(6 Dr,eekf 4�e P&- ohkt -)&- p, C'nfaw to P tch &&&k
Full Ground Water/Full Surface Water P itial Sa a/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample .Split: - Comments: - _»
Flow/Level: pH: Temp. EC. Other:
3. Site ID. : D(7QO1Q Ik Location: Cree(f -3:;?' , re 016 4!r e ctc-=
Full Ground Water/Full Surface Water/ artial Samp a/Geo./Soil/Grab/Composite/Filtered/Raw
Disposition: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
4. Site I 19' 6JJ-m7tr fran w'k en-t7 Cr
Full Ground Water/Full Surface Water/ al Sam p a/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: Time:
Sample Split: Comments:
Flow/Level: pH: Temp. EC. Other:
CHAIN OF CUSTODY
1. Transferred from: Larry To: Time/Date: /4/y-Jj�
1. Transferred from: tTo: Time/Date:
Received at Lab by: Date:
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