2003-09-23_REVISION - M1999034

• Permit No: M1999034
• IBM Index Class Name: Revision
• Doc Date: 9/23/2003
• Doc Name: Results of the Intital DIMP Testing
• From: ADCO Consulting
• To: DMG
• Type & Sequence: AM1
• Media Type: D
• Archive: No

- ~~ Laboratory and Radiation Services Division ~~i°""-'°~"', ~""~~.~''•" ~~.-~. °~~
°` ~~~ 8100 Lawry Boulevard, huwar 0080230-6928 ~ - t„~„~~ qr~~~~~~..y% ~F~ t,-.h,,. ''- `
US Mail: PO Box 1712: System ID ORG-2003000022 ~ r `
'. ~ [phone] fax ~ Collection Date `_``
~,°`~ 8/19/2003 1:45:OOPM ~ "'
-- °fP"61"He~ldt I - ....,.._... -w r'i~ c~a.+~v ;.. . .
2 ~1--5 ContralNumber I r-
andix*ir°»r '
. REQUEST FOR ANALYZ ~ CI ^
CustomerlD : WP013098
-Name : Paden-and Asseeiates
Address: 2090 East 104th ,"x202
City/StZp : Thotnton
Phone : [phone]
Contact: MazkMolen
~ Contad Phone
Collected:
Received: ~~_ao -aa
Co 80233 month day year
ollected by:
Time , a.m
L~
~ ~
° ,
~.p.m
hour min
Time
m
0 m
^ a.m
^ p.m
hour min
Water Type:
PWS ID : COO ~a a~ a a' a L ~ Purpose: ^Routine Special Purpose ~ Repeal
Name: ~. L - Chlorine residual: ~'~~ mg/L Temp., Water ©~oC
Address: }} ~
C~ ounry rare .'gyp Comments:
orauon --
TEST ORDER (Check appropriate box):

CHEPvIIS'iRY-INORGANIC
C3EM?STRY-dRGA_t.":C ,
RAS}IO"i3~ivIIS:RY '
^ Phase 1, 2, 5 G Alpha/Beta, Gross
^ Alkalinity, Phenolpathalein ^ ICP Scan ^ Solids, Total ^ VOC (Regulated) ^ Americium
G Alkalinity, Total G Lead ^ Sulfate ^ 600 (Regulated) ^ Gamma SpecVOmetry,
^ Aluminum ^ Lithium ^ Thallium ^ DBP (Regulated) NuGide Specific
^ Andmnny ^ Magnesium ^ Uranium ^ VOC (Screen) ^ p1u[onium
^ Arsenic ^ Manganese ^ Zinc ^ SVOC (Screen) ~ ^ Radium 226
^ Badum ~ ^ Mandatory ^ Other. ^ HEM (Oil & Grease) ^ Radium 226
^ Beryllium (Phase I, II. V) p THM ^ Radon

^ BOD ^ Merwry B~
^
^ Thorium

G Bomn ^ Molybdenum TOC
G ~ I M }~
^ Tritium
^ Cadmium ^ Nickel d
r Other.

^ Calcium (Carbonate) ^ Nitrogen, ^ Other. ^ Leak Test
ammonia, Oist
^ Other: ^ Alpha/Beta, Gross
G Chloride G Nitrogen, Kjeldahl ^ Carbon•74
^ Chlorine, Total residual ^ Nitrogen, Total ^ Other. ^ Ni-63
G Chromium G NiVOgen, NitrateMitriie ^ Other:
^
^ Chromium~Hexavalent G Nitrogen, Nitdie
^ Other:
H-3
^ Conductivity ~ PH IVIICROBZOLOGY ^ Other:
^ Copper ^ Phosphate, Ortho ^ Total Coliforms, PA ^ Other:
^ Corrosiviry (langlier) ^ Phosphate, Total ^ Total Coliforms, MTF
^ Cyanide, Distilled - ^ Potassium ^
Fecal Colifortns, MTF -
CPD
^ Cyanide, Direct ^ Selenium ^ E.Coli., MPN ^ VOC
G Cyanide, WAD ^ Silicon (silicates) ^ Heterotrophic Plate Count ^ Fat+ preservatives In Meat
^ Fluoride ^ Silver [~ pseudomonas Culture ^ Water Activity
^ Hardness fetal ^ Sodium - L~ Other:
G Heavy Metals ^ Solids, Dissolved
G Other.
^ Other:
^ Iron ^ Solids, Suspended

DISPOSITION CHAIN OF CUSTODY
S E //TIME
T~9/J" Z i 1;ECENED Y~
~C /r C. 4s~ece.s.r D /TIME p
y r r 2 /
ItF.i.T`iIQL77SHE Y: DATE /TIME RECEN DATE 3 c^.lu
RELINQUISHED BY: DATE /TIME RECEIVED BY: DATE !TIM
LABS Interent /
R250Req, Date of Modification:8/15/2003
i"1