Laserfiche WebLink
Laboratory and Radiation Services Division <br />8100 Lowry Boulevard, Denver CO tt0230-6928 <br />US Mail: PO Box 17123, Denver CO 80217 <br />~~~ (303) 692-3090 fax (303) 344-9989 <br />,.a r <br />REQUEST FOR ANALYTICAL SERVICES <br />~ • <br />.. <br />CustanerlD ~.1R fl ~~Z.g~ <br />-}' Name : ~ <br />~ Address: ~3~3~+~>~R~v.St-~vl,~-l~' <br />~~~~ ~ ~n~~~ C~ ~ O <br />e <br /> Pwsro: <br /> Sample Location: <br /> <br /> Description: <br /> Address: <br /> cit <br />: ~ <br /> y <br />~ <br />St ~Zrp: <br />/ 3Ystem tD <br />Collection Date <br />Control Number <br />Cdlection No: n~ <br />INO-2004000010 <br />1/5/2004 9:57:OOAM <br />7 <br />I <br />Collected.) I! ,/LJi-I/ULJ Time: LJIJ'LJ~ .J fpm. <br />rtranfh day Year hour min m' <br />Cdkcted py: ~ Matrbc <br />^ surface water <br />^ Ground Water <br />^ Treated Wafer <br />Purpose : ^ Routine ^ Special Purpose ^ Repeat ~ <br />Chlorine residual: ~e ^ ^ MGIL temp., Water. ^ I I F <br />Comments: <br />TEST ORDER (Cheek appropriate box) : 0 <br />CHEMISTRY-INORGANIC I CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />^ Alkalinity, Phenolphthalein ^ Moybdenum ~ ^ Carbamates ^ Alpha/Befa, Gross <br />^ Alkalinity, Top) ^ Nickel I ^ VOC ^ Ameridum <br />D Aluminum D Nitrogen. Amnania Dist ^ THM ^ Carbon-14 <br />^ Antinwny ^ N'drogen, IGekiahl D BTIX D Gamma Screen <br />D Arsenic ^ Nitrogen, Total ^ DIQUAT Gamma Spectrometry, <br />^ Barium D Nitrale/Nitdte D SOC ^ Nuclide Specific <br />~ BeryBirmt ^ Nitrite ^ SVOC ^ Leak Test <br />^ BOD ,r~ ~{ ^ Pesticides ^ Plutonium <br />D Boron D Phosphate, Orftro D Glyphosate ^ Radium 226 <br />^ ~nur^^ ^ Phosphate, Total ^ Herbicides ^ Radium 228 <br />^ Calcium D Potassium D EDBIDBCP ^.Radon <br />I <br />D ~~ D Selenium ^ PCB D Thorium <br />^ Chkxirre, total residual <br />^ Silicon (sificates) O TOC ^ Tritium <br />^ Chromium <br />i ^ ORO [] Other. <br />D Silver <br />^ ~~~~ ^ HEM (Od Grease) ^ Other. <br />^ Copper D Sodium ^ Other <br />^ Corrosivit (record tem . C Solids, Dissolved ^ Other. <br />MICROBIOLOGY <br /> <br />D solids, suspended <br />Cyanide, Dist w ., <br />Fluoride C Solids, Total ^ Total Cdifomu, PA <br />^ Hardness, tots! D SuMate Phase 1,2,5-ANALYSES ^ Total Colifomu, MTF <br />^ Iron D Thallium ~ ^ Heterotrophic Plate Count <br />D Lead ^ Uranium ^ Organic (SOC / VOC) ^ Pseudomonas MPN <br />D Magnesium ^ Zinc D Inorganic D E. Coll., MPN <br />^ Manganese C other. ^ Other. <br />^ Mercury ^ Other. ^ Otlter. <br />~temet Address: <br />ones aev twrAa <br />~~~ <br />i <br />