2011-11-08_HYDROLOGY - M1980244 - Laserfiche WebLink

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CustomerlD : 00009830 Name : Department of Natural Resources Address : 1313 Sherman Street Room 215 City /St/Zip Denver CO 80203 Phone : 303466 -3567 Email: Contact : Berhan Keffelow T/y, Ca z Fax: SAMPLE SITE Collected: (1– n h Collected by • l_��h d e ii year Timer Water sour Type: ' 0 0 m� min c a.m p.m . } J N` W Purpose: �j Routine ❑ Special Purpose • Repeat . Compliance ❑ Personal Information Chlorine residual: Fluoride 1 — mg /L Water Temperature D C PWS ID : COO System Name: I n UUU ---III I I ti - > , n t -- 3% m 9 IL >j 1 , Temperature at Receipt: Address: — Comments: OUR ae Ip CT— "r ,1 �}/� Jescripticn:• ` r`� '' l ` - O1_41)_ ` AR A rTT IIIIIra / 6ITA + ir m .' �S�,� -L�___ �/�1 � Lam, ■ Location Source • / ❑Rea% 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) OM filing 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 COMPLIANCE DRINKING WATER TESTS Organic Chemicals Rule Inorganic Pa a , et- s Organic Parameters °Alkalinity - ❑ BOD ❑CBOD ❑DO ❑Chemical Oxygen Demand (COD) ❑Chloride ❑Chlorine ❑Chromium, hexavalent (C( ❑Corrosivity (Langlier) Cyanide ❑ Direct D Distilled ❑ WAD ❑Fluoride ❑'Hardness CMercury Individual Metals ❑Aluminum ❑Antimony DArsenic ❑Barium ❑Beryllium ❑Cadmium ❑Calcium ❑Chromium ❑Cobalt ❑Copper ❑Iron ❑Lead ❑Magnesium ❑Manganese ❑Molybdenum ❑Nickel ❑Potassium ❑Selenium ❑Silver ❑Sodium ❑Strontium ❑Sulfur ❑Thallium ❑Tin ❑Tungsten ❑Uranium ['pine Nitrogen, ❑Ammonia !!`` ❑ Nitrate /Nitrite ❑ Total Kj Idahl ❑Nitrate ❑ Nitrite 0 p ❑Phenol Phosphorus ['Phosphate, Ortho ❑Phosphate, Toil 0Sodium_Alsorption Ratio Solidslssolved ❑Settleable ❑Suspended ❑Total °Volatile ❑Specific Conductance "Itt S ulfate ulfide ❑Turbidity ❑Other Inorganic: 0011 and Grease DVOCs Screen °SVOCS /Pesticide Screen ❑BTEX Radiochemistry DEDB /DBCP ❑Chlorinated Pesticides ❑PCBs (Subcontracted) ❑Chlorinated Herbicides ❑Volatile Organic Compounds (VOCs) OSemivolatile Organic Compounds (SVOCs) ❑Carbamate Pesticides DDiquat (Subcontracted) DEndothall DGlyphosate inorganic Chemicals Rule ❑Gross Alpha /Beta ❑Radium 226 ❑Radium 228 ❑Uranium 0C -14 ❑Radon ❑Ni -63 ❑Gamma Spectromel Specific Isotopes (list) OPrimary Metals (Sb, As Be, Be, Cd, Cr, Hg, Ni, Se, Na TI) + Fluoride ❑Primary Metals (Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Na TI) + Fluoride + Cyanide Nitrogen, ❑Nitrate ❑ Nitrite Lead and Copper Rule Food Testing ❑Lead and Copper Radionuclides Rule ❑Equilibrium pH ❑Starch ❑Fat ❑Water Activity Preservatives (list): ❑Gross Alpha /Beta °Radium 226 ❑Radium 228 ❑Uranium Disinfection Byproducts ❑Total Trihalomethanes (TTHMs) ❑Haloacetic Acids (HAASs) • ❑Alkalinity °Bromate ❑Bromide ❑Bromite ❑Chlorate ❑Chlorite Organic Carbon ❑Total ❑ Dissolved ❑UV @ 254 Total Coliform Rule (Microbioloav /Bacteria) ❑Mercury. Metals (list): ❑Bacteria in Food Suspect: Suspect: Miscellaneous ❑Total Collform (Present/Absent, w/ E. colt) ❑E. colt (Enumerated, wi Total Coliform) ❑Total Coliform (Multiple Tube enumeration) ❑Coliform, Fecal (Multiple Tube enumeration) ❑Heterotrophic Plate Count ❑Other Microbiology: ❑Soils /Filters -XRF metals (list): ❑Unknown Substance Identification (FTIR) - CHAIN OF CUSTODY• RELINQUI3 X.'" DACE /TI E: _ /d /z5 air / � /. RE Y �� DATE /T1M / t9/ 2- y' / // e• . ;5 4 DATE /TIME: rteueoulmittD' // DATE IME: i V RECEIVED BY: RELINQUISHED BY: DATE /TIME; RECEIVED SY: DATE/TIME: Colorado Dcpamnenr ofPoblicHealdt and Environment Laboratory Services Division 8100 Lowry Boulevard, Denver, CO 80230 -6928 US Mail: PO Box 17123, Denver, CO 80217 (303) 692 -3090 fax (303) 344 -9989 REQUEST FOR ANALYTICAL SERVICES CUSTOMER LSD Interent Address: http:// www. cdphe.state.co.us/Ir /Irhom.httn Report #250Req Collection No: SPECIMEN INFORMATION