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laboratory and Radiation Services Diu <br />8700 Lowry Boulp~°°13`J "'- <br />' ...- • US Mail' PO Bm <br />' (303) 692-3090 System ID <br />.rn,ur rrwa, <br />'°° e°„~.'m' Date <br />REQUEST FOR ANAL <br />Collection <br />Control Number <br />INO-2006003416 <br />8/25/2006 12:45:OOPM <br />2 <br />~ • <br />.. <br />p CustomerlD <br />'~' Name ~~1 J~.On ~tRYYU,'~on~ M InAnq ~ 5 <br />Address : f313 ~4,e./~yterl sf . #Z/5 <br />:.R ~~~' ~'lli?,rr PA~ ~LtQ <br />Contact: ~'~ ~-"- J <br />~ ~1O1e: 31t-,-~ol0-~1~3 <br />~ ~~ - <br />~ ~1D~ uuu~u~ <br />,~., ,~, pp ~ ~ <br />Sample Location: /Y- 'd~mllla ~~Lrn.!// tp oZ ~ <br />it f I If <br />Address: ~ (r.e-. <br />~. cay: ~t sl: rip: <br />I <br />Colk~cted:L!/JL4J~U~` L~1LL/J Time. ULI'L7JU ly~,m. <br />CdleUed by. ® Matrbc !"'" <br />^ surface water <br />^ Ground wager <br />^ Treated Water <br />Purpose: ^ RauBne ~SpedalPuryose ^ Repeat <br />Chlorine residual: ~a ^ ^ MG/L Temp., Water. ®~~ e <br />TEST ORDFJi (Check appropriate box) : O <br />CHEMISTRY-INORGANIC I CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />^ Afkalinily, Phenolphthalein ^ Molybdenum ~ - ^ Carbamates ^ Alphal8eta, Gross <br />^ AAcalmity, Total ^ N'xicel ~ ^ VOC ~ ^ Americium <br />Aluminum ^ Nitrogen. Ammonia Dxt. ^ THM ^ Carbon-14 <br />^ Antimony ^ Nitrogen, Kteklahl ^ BTEX ^ Gamma Screen <br />'`~ Arsenic ^ Nitrogen, Total ~ ^ DIQUAT Gamma Spedrametry, <br />^ Badum ^ Nibate/Nilrite Q SOC ^ Nuclide Specific <br />^ Berygium ^ Nitr~Oe ^ SVOC ^ LeakTest <br />^ ()pp ^ ~{ ^ Pesticides ^ Plutonium <br />^ Boron ^ Phosphate, ONw ^ Glyplwsate p Radium 226 <br />^ Cadmium ^ Phosphate, Total ^ Merbiddes ^ Radium 228 <br />^ Calcium p Potassium ^ EDIYDBCP don <br />^ Chbride ^ Selenium ^ PCB ^ Ttwdum <br />^ Chlorine, total residual <br />^ SAicon (silicates) ^ TOC ^ Tritium <br />^ Chromium ^ DRO ^ Other. <br />^ Conductivity ^ SrNer <br />' ^ HEM (Oct G e <br />^ Other. <br />^ Sod <br />wm <br />^ Copper ^ ~ . <br />^ Corrosivity (record temp) ^ SoBds, DissoMed ^ MICR08/OLOGY <br />^ Cyanide, Dist C7 Solids, Suspended <br />^ Fluoride ^ Solds, Total ~ ^ Total Coliforms, PA <br />^ Hardness, total ^ Sulfate <br />Ph a 1,2,5-ANALYSES ^ Total Colifomu, MTF <br />Iron ^ Thallium ~ ^ Heterotrophic Plate Count <br />~~ ^ Uranium ^ Organic (SOC / VOC) ^ Pseudomonas MPN <br />^ Magnesium ^ Znc ^ Inorganic ^ E. Coli., MPN <br />q Macanese ^ Other. ^ Other. <br />~ <br />15C Mercury ^ Other. <br />TT" . ^ Other. <br />l~ <br />c°ul(~I >`e~ Cu.ax'.cy,.~c... N~ ~/uor;de- SIZE/o3 /.'9.zp.m. <br />r . ~. ~ r ,, <br />LARS Internet Addre <br />R.v«r tea. R« i2mrss <br />-.euo-c~.~~n., .~ <br />(~ Al~gld~ <br />1 <br />~ ~.e.. -P,a-G-e-Q ~ -~4A- ,~-c~~--, n~- o~. ~ `~[. of .ern ~ <br />