Laserfiche WebLink
r <br />Laboratory and Radiation <br />8100 Lowry Boulevard, D <br />US Mail: PO'Box 17123, I System ID ENV-2009006788 <br />c (303) 692-3090 fax (303 <br />KWIC rr«an Collection Date 7/2/2009 9:10:00AM <br />Erfkonw-d ;lontral Number 47 <br />REQUEST FOR ANALYTIC. _ <br />- Name . C7 1?- ?`?U `Qx? 3 <br />Address : 13 ?3 S H rt 1.??'\Ucv12.? <br />tact <br />Phone ?.' ^b <br />rr- SAMPLE SITE <br />PWS ID: j <br />l'L Sample Location: Cp t? TA k W%Ibr D9 hd ?? O <br />Description: <br />?? <br />-- <br />AWress: <br />City: I SC Zrp: <br />Collected. <br />Time: I 1h 1:1 / (IAAam. <br />morrtlr day )e* hour min U r <br />Collected by: Mabbc <br />? Surface water <br />? Ground Water <br />? Treated Water <br />Purpose : ? Routine ? Special Purpose ? Repeat <br />Chlorine residual. Fla ? n MGJL Temp.. Water: F1 ? F <br />Comments: <br />TEST ORDER (Che <br />a A, <br />ck appropriate box) ':]N O <br />CHEMISTRY- INORGANIC CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />? Atkalnity, Phenolphthalein ? Molybdenum ? Ca <br />? Alpha/Bets. Gross <br />O Alkalinity, Total ? Wicket <br />? _ <br />- - <br />-? Americium_- <br />-O-Aluminum p flifrogen?nurwnia Dist ? Carbon-14 <br />O Antimony ? Nitrogen, Igeldshl ? Gamma Screen <br />? Arsenic ? Nitrogen, Total ? DIQUAT : Gamma Spectrometry, <br />? Barium ? Nkrate/Nitrite V O SOC ? Nuclide Specific <br />? Be~ O Nitrate O SVOC ? Leak Test <br />? BOO ? pH ? Pesticides ? Plutonium <br />? Boron ? Phosphate, Ortho ? Glyphosate O. Radium 226 <br />? Cadmium ? Phosphate, Total ? Herbicides O Radium 228 <br />? Cakdum ? Potassium ? EDt3IDBCP ? .Radon <br />? Chloride O Selenium ? PCB ? Thorium <br />? Chlorine, total residual ? Silicon (silicates) O TOC ? Tritium <br />? Chromium ? DRO ? Other. <br />O conductivity ? Silver ? HEM (Oil Grease) O Other. <br />? Copper ? Sodium O . <br />O Corrosivity (record temp) ? Solids, Dissolved ? Other MICROBIOLOGY <br />? Cyanide, Dist ? Solids, Suspended <br />? Fluoride ? Solids, Total ? Total CoGforms, PA <br />? Hardness, total ? Sulfate phase 1,2,5 -ANALYSES O Total Colifonns, MTF <br />O Iron ? ThaEum ? Heterotrophic Plate Count <br />I:1 Lead ? Uranium ? Organic (SOC / VOC) ? Pseudomonas MPN <br />? Magnesium ? Zinc ? Inorganic ? E. Col., MPN <br />? Manganese ? Other O Other. <br />[? Mercury O Other: ? Other. <br />i I G <br /> I <br /> <br />t.A1KS Intemet Address: http.//www.cdphe.state.co.usllrArhom.htm <br />R %d 9250Req, Rw 12M/99