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HomeMy WebLinkAboutWell Inspection 312 Deming Street STATE OF CONNECTICUT DEPARTMENT OF PUBLIC HEALTH DIVISION OF LABORATORY SERVICES BOTTLES RECEIVED P.O.BOX 1689-10 CLINTON STREET HARTFORD,CT.06144 PHONE: AREA CODE (860) GC/MS ORGANICS: 509.8522 ■ RESIDUE CHEMISTRY: 509-8547 ■ LABORATORY ACCESSION LABEL RADIATION: 509-8526 TOWN NUMBER: S06074/SOUT ROBERT DEPTULA r` SAN'ITAKIAN COLLECTOR'S INFORMATION 1540 SULLIVAN AVE DATE COLLECTED: TIME COLL.(00:00-24:00): TOWN HALL SOUTH WI NDsCIR r IwT 06074 SAMPLE INFORMATION COLLECTOR'S SAMPLE#: h I 1 lzl NAME OF UTILITY OR PROPERTY OWNER: 17)k IV W L COLLECTED BY(LAST NAME,FIRST NAME): 11- Ir 1 6 lh SOURCE: l-Dl& lnkhkkld [� dv-6 kill k0l COLLECTOR'S TITLE: ADDRESS(OF SAMPLE COLLECTION): 1�1+1 11-1 1 Id i ly,14 COLLECTOR'S PHONE#: TOWN OF SAMPLE COLLECTION: STATE: d "�l� h I& b!Ll+ITI , t-k k k 1 0 r Eo lily 1 ] REMARKS ADDITIONAL INFORMATION: COMPLAINTS RE UESTS TREATMENTS ETC. : ZIP CODE:IMAL I M loldo POTABLE WATER TEST REQUEST ORGANICS RADIATION ❑ 100J EPA 524.2 VOLATILE ORGANICS ❑916R EPA 900.0 GROSS ALPHA W010H EPA 504.1 EDB AND DBCP ❑917R EPA 900.0 GROSS BETA ❑ 1830 EPA 525.2 SEMI-VOLATILE ORGANICS ❑919R EPA 903.0 RADIUM 226 ❑ 1800 EPA 548.1 ENDOTHALL ❑918R EPA 904.0 RADIUM 228 ❑ 1060 EPA 505 ORGANOCHLORINE PESTICIDES ❑921R RADIUM 226 and 228 ❑ 1760 EPA 555 CHLORINATED HERBICIDES ❑915R EPA 913.0 RADON 222 ❑ 1780 EPA 531.1 CARBAMATES and CARBAMOYLOXIMES ❑920R EPA 908.0 URANIUM ❑ 1790 EPA 547 GLYPHOSATE ❑ 151R EPA 905.0 STRONTIUM 89 ❑ 1810 EPA 549.1 DIQUAT ❑ 152R EPA 905.0 STRONTIUM 90 13 1820 EPA 552.1 HALOACETIC ACIDS and DALAPON ❑ 155R EPA 902.0 IODINE 131 ❑ OTHER ❑511R EPA 906.0 TRITIUM ❑ 504R EPA 901.1 GAMMA- ❑ OTHER ■ OL-81C REV.10/98 ■