2003-08-06_HYDROLOGY - M1980244

• Permit No: M1980244
• IBM Index Class Name: HYDROLOGY
• Doc Date: 8/6/2003
• Doc Name: Sample Information
• From: CDPHE
• To: DRMS
• Media Type: D
• Archive: No

Laboratory and Radiation Services Division
300 8100 Lowry Boulevard, Denver CO 80230-6928
US Mail: PO Box 17123, Denver CO 80217
ce6„ee r [phone] fax [phone]
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REQUEST FOR ANALYTICAL SERVICES
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Address
Contact
Phone
C-bOM (6 66- (?n-ta--
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Sample location: ?'b•
t JV Description:
Address:
St zip.
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System ID 1NO-2008002823
Collection Date 7/17/2008 11:20:00.AM
Control Number 30
Collection No nnnnnnnn
Collected. ©rl i./aL?+ lJL8 Time: I, I?( I'L Jw O m.
mo m day year day Yew hour mm
Collected by: Matrbc
? Surface Water
? Ground Water
? Treated Water
Purpose : ? Routine ? Special Purpose ? Repeat
Chlorine residual: ?. ? ? MGIL Temp., Water. ? ? F
Comments:
TEST ORDER (Che ck appropriate box)
CHEMISTRY - INORGANIC CHEMISTRY - ORGANIC RADIOCHEMISTRY
? Alkalinity, Phenolphthalein ? Molybdenum ? Carbamates ? Alpha/Beta, Gross
--
- -
? AlkalinKy, Total _?_1fnkel --E1-VO6 -?-Ardpum -
O Aluminum ? Nitrogen. Ammonia Dist. ? THM ? Carbon-14
? Antimony ? Nitrogen, ICeidahl O BTEX ? Gamma Screen
? Arsenic ? Nitrogen. Total' O DIOLIAT Gamma Spectrometry,
? Nuclide Specific
O Barium ? Nitrate/Nitrite O SOC
? Beryllium ? Nitrite ? SVOC O Leak Test
? BOD ? PH ? Pesticides ? Plutonium
? Boron O Phosphate, Ortho ? Glyphosate ? Radium 226
? Cadmium ? Phosphate, Total ? Herbtades ? Radium 228
? Calcium ? Potassium EDBIDBCP
APCs ? .Radon
? Thorium
? Chloride ? Selenium
? Chlorine, total residual O Silicon (silicates) ? TOC ? Tritium
[3 Chromium ? DRO ? Other.

? Conductivity ? Silver ? HEM (Oil Grease) ? Other.

? Copper ? Sodium
? Other.
? Corrosivity (record temp.) O Solids' Dissolved O Other MICROBIOLOGY
? Cyanide, Dist 0 Solids, Suspended
? Fluoride ? Solids, Total ? Total Cordonns, PA
? Hardness, total Sulfate Phase 1,2,5 -ANALYSES O Total Coliforms, MTF
? Iron ? Thallium ? Heterotrophic Plate Count
L Lead ? Uranium ? Organic (SOC / VOC) ? Pseudomonas MPN
O Magnesium X.Zinc ? Inorganic O E. Coll., MPN
Manganese ? Other O Other.
[; Mercury ? Other: ..O Other.

I ?

LARS Internet Address: http://www.cdphe.state.co.us/ir/lrhom.htm t'
Repot #29MM Rev 120199 tom,