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,.. ~ III IIIIIIIIIIIIIIII Page ~ of ~ ~~3$7 <br />MINED LAND RECLAMATION DIVISION <br />MONITORING FACT SHEET <br />LABORATORY SAMPLES <br />Operation: ~ACLE 1°IIN~S <br />Company/Address: E--(D12E ENERloY Cp2P PO F. <br />Specialist: J/H..{g rr, STHIENS <br />Date: b 10 $-/ Time: RFTE~.~1o0tJ Weather: <br />Comments: f?oTl-F $hM711 ~ We~'.~ rZ/~6P5~ L~E7~1 <br />File dk: C'gl-0V-~L <br />A16,CD• I6 L6 Mine Contact: L, l?AHRlW <br />Cory: <br />1. sire ID.: wISE ~}IlL-~4 wE~L. Location: NR1v~. 5 3t-TG~u-iZ~+lw <br /> <br />Full Ground Water/Full I+AS 9~ <br />Surface Water artial Sampl /Geo./Soil/Grab/Composite Filtere /Raw <br />Disposition: FORWR~D 'P,lrSULTS TO DIVISION, EMPIPE E7JER6x Time: ~~~~ <br />Sample Split: 13~ Comments:`(~ooK30'35~All~RS~ 57pPPEb WF}q.1$LAEKDE3RIS Wp5 PIGKED uP <br /> <br />Flow/Level: - FRDN pooDr~ MII..E <br />pH: - Temp. - EC. - Other: woes N65 <br />2. Si[e ID.: Lu-K.FL2t5TWP PII $PPJAb Location: 5~%¢ N~%¢ 531- 16N-~'GIW <br /> <br />Full Ground Water/Full htAS HEN <br />Surface Water Partial Sampl /Geo./Soil/Grab/Composite iltere /Raw <br />Disposition: Fo2R.W1zD R~ULTSTD DIVISIONS EMPIRE t3,lc£Gy Time: AF7EP-pDON <br />Sample Split: NO Comments: TAKEN eLOSE'r0 SOURc.E~ LL~i42~ l7HE OF `-~NPUN6 <br />Flow/Level: - pH: - Temp. - EC. - Other: <br />3 <br />Site ID.: Location: <br />Full Ground Water/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: Temp. EC. Other: <br />4. Site ID.: Location: <br />Full Ground Fla ter/Full Surface Water/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: Temp. EC. Other: <br />5. Site ID.: Location: <br />Full Ground Water/Full Surface Wa[er/Partial Sample/Geo./Soil/Grab/Composite/Filtered/Raw <br />Disposition: Time: <br />Sample Split: Comments: <br />Flow/Level: pH: Temp. EC. Other: <br />CHAIN OF CUSTODY <br />1. Transferred from: To: Time/Date: <br />1. Transferred from: To: Time/Date: <br />Received at Lab by: Date r 7 ~~ <br />8934F OOOYRMO DYA <br />