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 : 303 - 866 -3567 Email: . Contact :: Berhan Keffelow/ 7 ;7 ,1 Cam,. 0 / OP Fax: Collected: I Collected by: I I� -� month day — — 1L ear ^ Tlme Water hour Type: ° ° ` I t { min GO a.m 0 p.m *W Purpose: ❑ Routine • Special Purpose J Repeat • Compliance fl Personal Information SAMPLE SITE Chlorine residual: a - mg/L Water Temperature _1 oC P W S ID : COO 3yst Name: { I 44 I I — n� fil__A.. / I ,1' _- Fluoride II I r mg/L f �r'�',r��>�r�, • Temperature at Receipt: Address: �U r 1 � Comme22nts: . + .I . UfL_.' *T t CAO.y C tY o Ip )escriptian: • C7 (A ) ► ' f (m_ � /l� �, / / 1 - / ,i art � Ar j�i!�j7 i�i':i_'mp �' L Location Source t MP 1{i�� ■r rn ❑Real Estate /HUD (Collform Bacteria, Lead, Nitrate and Nitrite) ❑Annual Colorado Package (Collform Bacteria, Nitrate/Nitrite) ❑Expanded Annual Colorado Package (Collform Bacteria, Nitrate /Nitrite, pH, TDS) ❑General Colorado Package (Arsenic, Collform 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, NitratelNitrite, 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, NitratelNitrite, Arsenic, Barium, Calcium, Chromium, Iron, Magnesium, Selenium, Sodium, Sulfur, and Uranium) ODrilling 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 f T Organic Chemicals Rule inorganic Parameters e n • era eters DAlkalinity ° BOD ❑CBOD ❑DO CI Chemical Oxygen Demand (COD) °Chloride ❑Chlorine ❑Chromium, hexavalent (Cr *6 ) ❑Corrosivity (Langlier) Cyanide ❑ Direct ❑ Distilled ❑ WAD ❑Fluoride ❑Hardness ❑ Mercury Individual Metals DAluminum ❑Antimony ❑Arsenic ❑Barium ❑Beryllium ❑ Cadmium ❑Calcium ❑Chromium ❑Cobalt ❑Copper ❑iron ❑Lead ❑Magnesium ❑Manganese ❑Molybdenum 00 i and Grease ❑VOCs Screen ❑SVOCS /Pesticide Screen ❑BTEX Radiochemistry ❑EDB /DBCP ❑Chlorinated Pesticides ❑PCBs (Subcontracted) ❑Chlorinated Herbicides ❑Volatile Organic Compounds (VOCs) ❑Semivolatile Organic Compounds (SVOCs) ❑Carbamate Pesticides ❑Diquat (Subcontracted) ❑Endothall ❑Glyphosate inorganic Chemicals Rule ❑GrossAlpha /Beta ❑Radium 226 ❑Radium 228 ❑Uranium ❑C -14 ❑Radon ❑Ni -63 ❑Gamma Spectromet Specific Isotopes (list) ❑Primary Metals (Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Na Ti) + Fluoride ❑Primary Metals (Sb, As, Ba, Be, Cd, Cr, Hg, Ni, Se, Na Tl) + Fluoride + Cyanide Nitrogen, ❑Nitrate ❑ Nitrite Lead and Copper Rule Food Testing ❑Nickel ❑Potassium ❑Selenium ❑Silver ❑Sodium ❑Strontium ❑Sulfur ❑Thallium ❑Ti ❑Tungsten ❑Uranium inc Nitrogen, ❑Ammonia ' ❑ NitratelNitrite ❑ Teta jki hl ❑Equilibrium pH ❑Starch ❑Fat ❑W ate r Activity Preservatives (list): ❑Lead and Copper Radionuclides Rule ❑Gross Alpha /Beta ❑Radium 226 ❑Radium 228 ❑Uranium Disinfection Byproducts ❑Nitrate ❑ Nitrite ❑pH ❑ Phenol Phosphorus ❑Phosphate, Ortho ❑Phosphate, Total ❑Sodium Adsorption Ratio Solids t pissolved ❑Settleable ❑Suspended l7 Total ❑Volatile ❑Specific Conductance R7uSUlfate Sulfide ❑Turbidity ❑Other Inorganic: ❑Mercury. Metals (list): ❑Total Trihalomethanes (TTHMs) ❑Haloacetic Acids (HAA5s) ❑Alkalinity ❑Bromate ❑Bromide ❑ Bromie ❑Chlorate °Chlorite Organic Carbon ❑Total ❑ Dissolved ❑UV @ 254 Total Collform Rule (Microbiology/Bacteria) ❑Bacteria in Food Suspect: Suspect: Miscellaneous ❑Soils /Filters - XRF metals (list): • ❑Total Coliform (Present/Absent, w/ E. coil) ❑E. coil (Enumerated, w /Total Coliform) ❑Total Coliform (Multiple Tube enumeration) ❑ Coliform, Fecal (Multiple Tube enumeration) ❑Heterotrophlc-Plate Count ❑Other Microbiology: ❑Unknown Substance Identification (FTIR) - CHAIN OF CUSTODY: RELINQUISHED BY: � = i . DATE IM : �/ 1 : J3- //�L- - f� R 0-- r r 7�yc�y�� a' — g g 7y 2 y �f r� /il l RELINQUISHED BY: if DATE ME T RECEIVED eV: DATE/TIME: RELINQUISHED BY: DATE/TIME: RECEIVED BY: DATE/TIME: Colorado Dcparmnent of Public ieatdt and llnvirontnent 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 /lrhom.htm Report #250Req Collection No: n SPECIMEN INFORMATION J jy