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/~ <br />Laboratory and Radiation Services Division ~ - <br />• 8100 Lowry Boulevard, Denver CO 80230-692f System ID <br />• US Mail: PO'Box 17123, Denver CO 80217 Collection Date <br />°K (303) 692-3090 fax (303) 3449989 Control Number <br />..w ~.~~ <br />.~ <br /> <br />uC <br />.~ <br />Q. <br />RE~~IEST FAR ANALYTICAL SERVICE. <br />CustwnerlD <br />Name : ~t~~;~,aN, 1~'f~l ~ZSL~ _ <br />Address: (-~l~ Stt ~L~ $~ ~2.IVl~b <br />ShW~d' h5 •~6a~Dc3' <br />Pws lD: <br />Sample location: ~ ~"~_` '~` l ~~-I'~. <br />~• ~ (S <br />Address: <br />Cdy: <br />St Zrp: <br />~_.- <br />INO-2008001243 <br />3/27/2008 9:07:00 <br />402 <br />Collected: ~~~~ I/' ~ IL~J~LSdJlL1J Time: ~LLJ ~IJLJ am. <br />l ma~rlhl ~I LJday year hour mb ^ p.m. <br />Cdlected by: .:~ Matroc <br />^ surface water <br />^ Ground wooer <br />^ Treated water <br />Purpose : ^ Routine ^ Speaal Purpose ^ Repeat <br /> <br />Chlorine residual: Q a ~ ~ MGIL Temp., Water. ^ ^ p <br />I Comments: <br /> TEST ORDF~ (Check appropriate box) : ~ <br />CHEMISTRY- INORGANIC CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />^ ANcapnity, Phenolphthalein ^ Molybdenum ^ Carbamates <br />^ AlphalBeta <br />Gross <br />O Alkalinity, Total ^ N'~ckel O VOC , <br />^ Ameridum <br />D Ahrminum ^ Nitrogen, Ammonia Dist ^ THM ^ Carbon-14 <br />D Antimony D Nitrogen, lyeldahl ^ BTEX ^ Gamma Sueen <br />O Arsenic ^ Nitrogen, Total <br />D Barium ~ ~ ~~~ !~ ^ DIQUAT Gamma Spedrornetry <br />^ Nud'de Specific <br />^ Berypiurrr ^ SVOC <br />^ Leak Test <br />^ tiOD ^ ~ ^ Pester ^ Plutonium <br />^ ~~ <br />. D Phosphate, Orfho ^ Glyphosate ^ Radium 226 <br />^ Cadmium D Phosphate. Total ^ Herbiades ^ Radium 228 <br />^ Caldum O Potassium ^ EDt3/DBCP ^ .Radon <br />^ Chbride D Selenium p PCB ^ Thorium <br />^ Chkxine, total residual <br />^ Silicon (silicates) ^ TOC <br />^ Tr~ium <br />^ Chromium ^ Srlver D DRO ^ Other. <br />Q Condurdinrity ^ HEM (Op Grease) ^ Other <br /> <br />^ Copper <br />^ Sodium <br /> <br />^ Other. . <br />^ Co ' ' temp.) ^ Solids, OissoMed ^ other. <br /> <br />Cyanide, Dist. ~ <br />d Solids, Suspended M/CROBlOLOGY <br />i~luoride D Solids, Total <br /> <br />^ Hardness <br />total <br />^ ~~~ ^ Total Copforms, PA <br />, <br />^ Iron <br />^ Thallium Phase 1,2,5 -ANALYSES ^ Total Coliforms, MTF <br />L Lead ^ p~~ ^ Heterotrophic Plate Count <br /> p Organic (SOC! VOC) ^ Pseudomonas MPN <br />G Magnesium ^ Zinc ^ Ino ank <br />~ <br />^ E. Cop., MPN <br />D Manganese [] Other: ^ Other. ~ <br />G+ Mercury ^ Other' - . f> Other. ~ <br /> ~ <br /> I I <br /> <br />.:x <br />W <br />S Internet Address: http://www.cdphe.state.co:us/IrAfiom.htm ~ ~ <br />yea. a.r ~zorgs <br />