2008-10-16_HYDROLOGY - M1999034

• Permit No: M1999034
• IBM Index Class Name: HYDROLOGY
• Doc Date: 10/16/2008
• Doc Name: Postponing Aggregate DIMP Sampling Program
• From: Molen & Associates, LLC
• To: DRMS
• Permit Index Doc Type: Hydrology Report
• Email Name: DB2
• Media Type: D
• Archive: No

Laboratory and Radiation Services Division
8100 Lowry Boulevard, Denver, CO 80230-6928
US Mail; PO Box 17123, Denver, CO 80217
[phone] fax [phone]
Cotaado
wdEwAmumm
Svstem ID ORG-2008000090
Collection Date 6/10/2008 2:35:00PM
Control Number I
REQUEST FOR ANALYTICAL SERVICES
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CustomerlD : WP013098
Name : Molen and Associates I,I.C
Collected: ? b
Time °
Address : 2090 East 104th #202
month day year
hour min p.m
CitylStlzip : Thornton Co 80233
Phone: Received: ??_?? ?? Time o ? a.m

303-450-1500
Contact :
Mark Molen

month day year ? p.m

hour min
Contact Phone : Collected by: Water Type:
SAMPLE SITE COMM ENTS
PWS ID: Coo ? ? ? ? _ ? r I FE] Purpose: Routine E] Special Purpose E Repeat
Name;
Address: Chlorine residual: a'1 11 I mg/L
LLLJJJJJILLLLJJJJJ QC
Temp., Water In
111
Temperature at Receipt: -
City Goon state rp
Description: p l' om
. r
Location Source ontofl top C
TEST ORDER (Check appropriate box):
CHEMISTRY-INORGANIC
? Alkalinity, Phenolpethalein 13 ICP Scan 13 Solids
Total CHEMISTRY-ORGANIC RADIQCHFMISTRY
,
? Alkalinity, Total ? Lead C3 Sulfate ?
Y
$ ? Alpha/Beta, Gross

? Aluminum ? Lithium O Thallium C'
13 VOC (Regulated)
? SOC (Regulated) ? Americium
? Gamma Spectrometry

? Antimony ? Magnesium O Uranium
? Ars
i
? DSP (Regulated) ,
Nuclide Specific
en
c ? Manganese ? Zinc
? Barium ? Mandatory ? Other: 4 VOC (Screen) ? Plutonium

? Beryllium (Phase 1, II, V) ? SVOC (Screen) ? Radium 226

? BOD ? Mercury
? HEM (Oil $ Grease) ? Radium 228
? Molybdenum
C3 BOD, Carbonaceous ? THM ? Radon
?
1:3 Boron Nickel E3 BTEX ? Thorium
? Automated Ammonia
? Cadmium
? Nit ? TOC
Other. (1 ? Uranium
rogen, Kjeldahl
? Calcium (Carbonate)
? Other: O Leak Test
? Nitrogen, Total
E3 Chloride 11 Other: ? Alpha/Beta, Gross
13 Chlorine, Total residual C3 Nitrogen, Nitrate/Nitrite
13 Other: El Carbon-14
? Chromium ? Nitrogen, Nitrite
? Nitrogen, Nitrate ?o
E3 Conductivity
Other:
POth
.,; ? Ni-63

? H-3
13 Copper ? pH er:

13 Phosphate, Ortho ? Corrosivity (Langlier) rye
MICROBIOLOGY ? Other:

? Cyanide, Distilled ? Phosphate, Total ,
? Total Coliforms, PA
? Other:
? Cyanide, Direct ? Potassium ? Total CDliforms, MTF

? Selenium
? Cyanide, WAD
? Fecal Coliforms, MTF
CiPD
? Fluoride ? Silicon (silicates) ? E.Coli., MPN E3 VOC
? Hardness total 13 Silver ? Heterotrophic Plate CQUnt ? Fat + preservatives in Meat
? Heavy Metals I] Sodium ? Pseudomonas Culture' ? Water Activity

? Solids, Dissolved
? Iron
? Other:
? Other:
? Solids, Suspended ? Other;
-I I ISPOSITION . „ fN"A ,.r r.t•,.. --
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47 ej Ir (? r(P _ 1 ru k -// ICJ .S
RI LINQUISH BY, DATE P TIME RECEIVED BY: DATE I TIME
kEIJNQUISI ED BY: DATE ! TIME RECF.IVE,D BY: DATE / TIMk
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LARS Interent Address: http://www.edphe.state.co.us/lr/lrhom_htm Report 4250Req, Late of Mod ifi cation:6/2/2008