Laserfiche WebLink
Laboratory and Radiation Services Division <br />8100 Lowry Boulevard, Denver CO 802308928 <br />• ~•rt US Mail: PO Box 17123, Denver CO 80217 <br />l (303) 692-3090 fax (303) 344-9989 <br />~, Z~~313~0 <br />REQUEST FOR ANALYTICAL SERVICES <br />.. <br />~' <br />-1- <br />,~ <br />CustomedD <br />Cdled'ron No: <br />Collected: <br />Tune: <br />Name: QC~ r~MV k1~Z~ LJL~-1~ r r v MILLI uiu -ULJ ~P.m. <br />SJ{ ~.~,~p.~ ,1 p~ mormr day year ~ar min <br />Address: ` 13 ~s`t`,F+'ti i`'i\a~~^ ''Collected by. ~ Matruc: <br />city/sr/zrp:~~V t~ C_I:) L~303 <br />Contact: S~1'1h~pi1S ~h~~G ^ Serrate Water <br />Phone:a0~ ~ ~/6~~~~~ I ^ Treated Water <br />PWS ID: <br />sample Location: ACT - ~ ~!' I~t PE's <br />: <br />Address: <br />/ Cdy. <br />St 2rp: <br />Puryr.•e : ^ Routine ^ Special Puryose ^ Repeat <br />Chlorine residual: -~~ ^ ^ MGlL - -Temp., Water. ^ ~ F <br />Comments: <br />TEST ORDER (Cheek appropriate box) : ~ L <br />CHEMISTRY- INORGANIC CHEMISTRY- ORGANIC RADIOCHEMISTRY <br /> <br />^ Alkalinity, Phendphthalein ^ Molybdenum I <br />~ ^ Carbamales <br />^ AlphalBeta, Gross <br />^ Alkalinity, Total ^ Nickel I ^ VOC <br />. <br />- <br />~,-~- r _ ^ Americium -_ <br />-- - - - - <br />F ^ Numin'um . ` - ~ O Nitrogen, Ammonia Dist _^. THM~- <br />. <br />- <br />I ~ _ ^ Cadwn-14 <br />^ Antinany ^ Nitrogen, IGeklahl ^ BTF7C ^ Gamma Screen <br />^ Arsenic ^ Nitrogen, Total ^ DIQUAT • ! Gamma Spectrometry, <br />^ Badum ^ Nitrate/NRrite I <br />^ SOC ^ Nudide Specific <br />^ Beryllium ^ Nitrite ^ SV~ ^ Leak Test <br />^ gOp ^ PH ^ Pesfiddes ^ Plutonium <br />^ ~r~ ^ Phosphate, ONm ^ Glyphosate ^ Radium 226 <br />^ Cadmium ^ phosphate, Total ^ ~~~ ^ Radium 228 <br />^ Calaum ^ Potassium ^ EDBIDBCP ^.Radon <br />^ Chloride C Selenium - ^ PCB ^ Thorium <br />^ Chkxine, total residual <br />^ Silicon (siGCates) ^ TOC ^ Tritium <br />^ Chromium ^ DRO ^ Other: <br />I <br />~~ ^ Silver <br />^ u~h~--- <br />- -- ^ HEM (Oil Grease) l] Other. <br />~ Sodium <br />^Copper ether: <br />^ _- ~ - - <br />' record temp.) ^ Solids, Dissolved ^ Other: MICROBIOLOGY <br />^ C snide, C Solids, Suspended <br />^ Fluoride ^ Solids, Total ^ Total ColNorms, PA <br />^ Hardness, total ^ SuHate phase 1,2,5 -ANALYSES ^ Toal Colifomu, MTF <br />^ Iron ^ Thallium - ^ Heterotophic Plate Count <br />^ Lead ^ Uranium I ^ Organic (SOC / VOC) ^ Pseudomonas MPN <br />^ Magnesium ^ Zinc ^ Inorganic ^ E. Coli., MPN <br />~ <br />^ Manganese ^ Ottrer. ^ Other. <br />_n, Mercury ^ Other. ^ Other. <br />LARS Internet Address: http://www.cdphe.state.co.us/IrArhom.htm ' <br />Repast 025roReV. Rev 17A7/99 ~~ <br />