2012-10-05_HYDROLOGY - C1981008

• Permit No: C1981008
• IBM Index Class Name: Hydrology
• Doc Date: 10/5/2012
• Doc Name: WET Testing - No Pattern of Toxicity Outfall 013 ‎(CO-0000213)‎
• From: Western Fuels Colorado
• To: WQCD
• Email Name: MLT
• Email Name: SB1
• Media Type: D
• Archive: No

Client /Project Name: tam \°t.)(t- 1.40 .I.lh
applicable)
P.O. /Project Number: 0 PD5Is 1 ;
WET: Acute (Indicate Below)
WET: Chronic (Indicate Below)
WET: Accelerated (Indicate Below)
WET: PTI /TIE /TRE (Indicate Below)
Metals (List Below)
Solids (TS /TDS /TSS) (Circle)
Anions (List Below)
Chromium III /VI (Circle)
aseaaD pue lip
Coliform (Total /Fecal /E -Coli) (Circle)
BOD /COD (Circle)
Other Analysis (List Below)
Number of Containers
Total Volume
Contact: 1 n md. Fizy
Address: 2'1 (,44.. VJ r e Aucit._ I.\ iC1.k .--0 g i
Phone # 1 I' g , 4 °-4S1O
,
E- Mail: "Irc..y(E)rl.3j- C,Wuc�..., CA
Fax # 990 $4.4- 2.1 a
Sampler: 714..
Report By: ❑MailDF FAX
Sample Location or I
Date
Time
Grab/
Comp
Lab ID
ILAB Use Only!
by
'
4,
T urr i4 mund tequiretnents'
tAnalvticat Test'na Only)
Test Species: ❑ Fathead Minnow aeriodaphnia ❑ Daphnia magna ❑ Daphnia pulex
Other (List Below)
•
Standard (10
days)
6-9 Day
1 -2 Day
Special Instructions /Comments:
3 -5 Day
Requested Report Date:
' Reliriqurished By (1),
Received By (1) _
Relinquished By (2)
. Received By (2) , ,
Signature
Date/Time Z
Signature f _ ? J,
Da te /Time
Signature
Date /Time
Signature
—
Date/Time
L acc'tru
Ytn6M1 NY
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