Laserfiche WebLink
8 <br />f Laboratory and Radiation <br />8100 Lowry Boulevard, D <br />US Mail: PO'Box 17123, 1 System ID ENV-2009006785 <br />c? mp? (303) 692-3090 fax (303 <br />iir'6 orh4fietre" Ollectim Date 7/2/2009 9:40:OOAM <br />"rrr.onwK- Control Number 44 <br />REQUEST FOR ANALYTIC.._ ___ _ _ _ <br />? • SAMPLE <br />IN FORMATION <br /> -- <br />Crrstamerl0 ? ? ?'K:. ? C?t_J .777 cowed <br />ai <br />l / W 7 Q <br />Time: ? V am. <br /> Name a k exy <br />.al , <br />Address * <br />mora? day year <br />hour min ?0 <br /> &? X03 colleted by WMI] Maw r F <br /> <br />Y//: <br />CR <br />A Contact: S >s S /%%0 Ve? ? Surface Water <br /> Phone :?, <br /> <br />? 0E? u O <br />O <br />Water <br />a T eat <br /> SAMPLE <br /> Pvvs ID: o 1 <br /> Purpose: ? Routine ? Special Pu rpose ? Repeat <br /> Sample Location: , -- > - <br />D <br />Chlorine msiduah ? ? ? MG& <br />Temp- Water. [IF] F <br />g Address: <br />- <br />Comments: -AUd-02 <br />..r <br />City' St: Zip. <br />? <br /> TEST ORDER (Che ck appropriate box) : Q <br />CHEMISTRY- INORGANIC CHEMISTRY- ORGANIC RADIOCHEMISTRY <br />? Aflinity, Phenolphthalein ? MoWenum O Cloamat% ? Alpha/Bete, Gross <br />? Alkalinity, Total ? Nickel ? %fc ? Americium <br />- <br />O-Aluminum _ O-Nifro?en? Ammonia-Dist ? ? Carbon-14 <br />O Antimony p Nitrogen, Igeklahl B ? Gamma Screen <br />? Arsenic ? Nitrogen, Total* DIQUAT Gamma Spectrometry, <br />? <br />O Barium <br />? Beryllium O Nitrate/Nitrite 1 <br />? Nilrite 0 O SOC <br />? SVOC Nuc ide Specific <br />O Leak Test <br />? BOO ? pH <br />` ? Pesticides ? Plutonium <br />? Boron O Phosphate, O <br />r ? Glyphosate ?, Radium 226 <br />? Cadmium ? Phosphate, Total ? Herbicides ? Radium 228 <br />? Calcium ? Potassium O EDSWCP ? .Radon <br />? Chloride ? Selenium ? PCB ? Thorium <br />C Chlorine, total residual ? Silicon (silicates) ? TOC ? Tritium <br />? Chromium O DRO ? Other. <br />? Conductivity O Serer ? HEM (Od Grease) ? Other. <br />? Copper ? Sodium ? Other <br /> ? Solids, Dissolved ? Other MICROBIOLOGY <br />C anide, Dist 1- ? Solids, Suspended <br />O Fluoride O Solids, Total ? Total Coliforms, PA <br />? Hardness, total ? Sulfate Phase 1,2,5 -ANALYSES ? Total Colifonns, MTF <br />? Iron ? Thallium ? Heterotrophic Plate Count <br />1:3 Lead ? Uranhrrn ? Organic (SOC / VOC) ? Pseudomonas MPN <br />? Magnesium ? Zinc ? Inorganic ? E. Coll., MPN <br />? Manganese ? Other ? Other. <br />? Mercury ? Other: <br />A ? Other. <br /> <br /> f <br />C5 <br />CD <br />LARS Intemet Address: http://www.edphe.state.co.usAr/lrhom.htm -- <br />Report 82SMaq, Rw 12MM <br />X:th