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: `� V.5TF ' „�� �° ' *::; „
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P.O. Project Number:
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1 .� 1o iE T . 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)
Oil and Grease
Coliform (Total /Fecal /E -Coli) (Circle)
BOD /COD (Circle)
Other Analysis (List Below)
Number of Containers
Total Volume
Contact: {,
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Address: 3. 4, ' , r- ► t 0
Phone # ” 7"
E- Mall: ft ,V \RA )CdU • ,:
Fax # `l 7 - 564 21 41
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Report By: C 7 Mail DF 0 FAX
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Turnaround Requirements
(Analytical Testing Onlul
Test Species: athead Minnow '° ceriodaphnia El Daphnia magna Q Daphnia pulex ❑ Other (List Below)
Standard (10 days) 6-9 Day
Special Instructions /Comments:
3 -5 Day 1 -2 Day
Requested Report Date:
Relinquished By (1)
Received By (1)
_ Relinquished By (2)
Received. By (2)
Signatur
Date /T,m t �
Signature
Date/Time
Signature
Date /Time
Signature „, �/
Date/Time
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CHAIN OF CUSTODY
Cannon Street Louisville, CO 80027
(303) 661.932 03) 661.9325