1993-11-15_GENERAL DOCUMENTS - C1981017

• Permit No: C1981017
• IBM Index Class Name: GENERAL DOCUMENTS
• Doc Date: 11/15/1993
• Doc Name: Bid Documents ‎(IMP)‎ Hydrology Correspondence Part ‎(2 of 2)‎
• Permit Index Doc Type: General Correspondence
• Media Type: D
• Archive: No

Page f '
MINED LAND RECLAMATION DIVISION
MONITORING FACT SHEET
LABORATORY SAMPLES
Operation - File #:
Company/Address: - - Mine Contact : �. , .
Specialist : -,r
Date: Time: - Weather:
Comments: r,;: Laboratory:
1. Site ID. _ . / Location:
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composit< ilte�O/Raw
Disposition: +� ,! ! y Time: '(
Sample Split : Comments :
Flow/Level i �� T = pH _Temp. L, -DEC. „ �j Other:
Site ID. :- + T Location
/Full Ground WaterfFull Surface Water/Partial Sample/Geo./Soil/Grab/Composi�e/,F ltered'IRaw=
-Dispositionr�% ( � r;- l l- !-f r Time:
J
Sample Split : t Comments :
Flow/Level: pH Temp. EC. Other:
3. Siter' Location: r
-
Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/ 'ltere'd/Raw
Disposition: Time: -
Sample Split : Comments:
Flow/Level pH:�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 :
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 i
1. Transferred from: c To: ' Time/Date: { `
1. Transferred from: To: Time/Date:
Received at Lab by: Date:
8934F 0 0 0 Y R M 0 D Y A
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