2011-08-02_HYDROLOGY - M1980244 - Laserfiche WebLink

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of P ub Dcp ealth j3 of 1�ublic ealth and Environment t an $ O R ANALYTICAL CustomerlD: Name: Address : City /St/Zip : Phone : Email: Contact : Fax: PWS ID : COO System Name: Address: Description: Laboratory Services Division 8100 Lowry Boulevard, Denver,, US Mail: PO Box 17123, Denve (303) 692 - 3090 fax (303) 34 00009830 Department of Natural Resources 1313 Sherman Street Room 215 Denver CO 80203 303 - 866 -3567 Berhan Keffelow Location City u s.— Source System ID Collection Date Control Number Collected: Collected by: Purpose: Fluoride LSD Interent Address: http:// www .cdphe.state.co.us /lr /lrhom.htm Report #250Req ENV - 2011007892 7/14/2011 9:47:00AM 32 SAMPLE SITE ❑Real Estate /HUD (Coliform Bacteria, Lead, Nitrate and Nitrite) ❑Annual Colorado Package (Coliform Bacteria, Nitrate /Nitrite ❑Expanded Annual Colorado Package (Coliform Bacteria, Nitrate /Nitrite, pH, TDS) ❑General Colorado Package (Arsenic, Coliform Bacteria, Hardness, Copper, Fluoride, Iron, Lead, Nitrate /Nitrite, Uranium) ❑Deluxe Colorado Package (Alkalinity, Arsenic, Cadmium, Calcium, Coliform Bacteria, Chloride, Conductivity, Copper, Corrosivity, Fluoride, Hardness, Iron, Lead, Magnesium, Manganese, Nitrate /Nitrite, pH, Sodium, Sodium Adsorption Ratio, Sulfate, Total Dissolved Solids, Uranium, Zinc) ❑Mining Baseline Package (pH, Nitrate /Nitrite, Aluminum, Arsenic, Cadmiun, Copper, Iron, Lead, Magnesium, Manganese, Potassium, Selenium, Sodium, Sulfur, Uranium, Sulfate, Gross Alpha /Beta) ❑Mining Baseline Package without Gross Alpha /Beta ❑Drilling Baseline Package (Volatile Organic Compound Screen, pH, Total Dissolved Solids, Chloride, Fluoride, Alkalinity, Sulfate, Nitrate /Nitrite, Arsenic, Barium, Calcium, Chromium, Iron, Magnesium, Selenium, Sodium, Sulfur, and Uranium) ❑Drilling Baseline Package without VOC screen. ❑Metals Scan: (Aluminum, Arsenic, Barium, Beryllium, Cadmium, Calcium, Chromium, Copper, Iron, Lead, Magnesium, Manganese, Molybdenum, Nickel, Potassium, Selenium, Silver, Sodium, Uranium, Zinc) CHAIN OF CUSTODY: RELINQUISHED BY: RELINQUISHED BY: RELINQUISHED BY: COMPLIANCE DRINKING WATER TESTS raanic ❑EDB /DBCP ❑Chl nated Pesti OP s (Subcontr ❑C orinated He ❑ - rganic!Coitfpouhds (VOCs) ❑Semivolatile Organic Compounds (SVOCs) OCarbam ate Pesticides ❑Diquat (Subcontracted) ❑Endothall OGlyphosate Inorganic Chemicals Rule OPrimary Metals (Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Na TO + Fluoride OPrimary Metals (Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Na TO + Fluoride + Cyanide Nitrogen, ONitrate ❑ Nitrite Lead and Copper Rule OLead and Copper Radionuclides Rule OGross Alpha /Beta ORadium 226 ORadium 228 OUranium Disinfection Byproducts OTotal Trihalomethanes (TTHMs) ❑Haloacetic Acids (HAA5s) ❑Alkalinity ❑Bromate ❑Bromide ❑ Bromie ❑Chlorate ❑Chlorite Organic Carbon OTotal ❑ Dissolved ❑UV @ 254 Total Coliform Rule (Microbiology /Bacterial OTotal Coliform (Present/Absent, w/ E. coli) ❑E. coli (Enumerated, w/ Total Coliform$ OTotal Coliform (Multiple Tube enumeration) ❑ Coliform, Fecal (Multiple Tube enumeration) ❑Heterotrophic Plate Count ❑Other Microbiology: SPECIMEN INFORMATION DATE/TIME: DATE/TIME: DATE /TIME: Inorganic Parameters ❑Alkalinity ❑ BOD ❑CBOD 000 CI Chemical Oxygen Demand (COD) ❑ Chloride ❑ Chlorine ❑ Chromium, hexavalent (Cr ❑Corrosivity (Langlier) Cyanide ❑ Direct ❑ Distilled ❑ WAD ❑ Fluoride ❑ Hardness 0 Mercury Individual Metals ❑Aluminum ❑Antimony ❑Arsenic OBarium OBeryllium 0 Cadmium ❑Calcium ❑Chromium ❑Cobalt ❑Copper ❑Iron ❑Lead ❑Magnesium ❑Manganese 0 Molybdenum ONickel ❑Potassium 0 Selenium ❑Silver ❑Sodium ❑Strontium ❑Sulfur ❑Thallium OTin ❑Tungsten ❑Uranium OZinc Nitrogen, ❑Ammonia ❑ Nitrate /Nitrite ❑ Total Kjeldahl ❑Nitrate ❑ Nitrite 0 p ❑ Phenol Phosphorus OPhosphate, Ortho OPhosphate, Total 0 Sodium Adsorption Ratio Solids ODissolved ❑Settleable • ❑Suspended OTotal OVolatile Conductance e ❑ Turbidity ❑ Other Inorganic: RECEIVED BY: RECEIVED BY: RECEIVED BY: month Temperature at Receipt: Comments: year S Routine ❑ Special Purpose 0 Compliance 0 Personal Information Chlorine residual: a , 00 mg /L Water Temperature D ' LE10 mg /L P11 . E=1. J LJ Time I hour Water Type: ❑ Repeat 110 OMercury Metals (list): DATE/TIME: DATE /TIME: o C DATE /TIME: 7 /, € a.m fa mm P•m Organic Parameters ❑Oil and Grease ❑VOCs Screen ❑SVOCS /Pesticide Screen OBTEX Radiochemistry OGross Alpha /Beta ORadium 226 ORadium 228 ❑Uranium ❑C -14 ❑Radon ❑ N i -63 ❑Gamma Spectromet Specific Isotopes (list) Food Testing ❑Equilibrium pH ❑Starch ❑Fat OWater Activity Preservatives (list): ❑Bacteria in Food Suspect: Suspect: Miscellaneous ❑Soils /Filters - XRF metals (list): OUnknown Substance Identification (FTIR)