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HomeMy WebLinkAboutWell Inspection 350 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) GUMS ORGANICS: 509-8522 ■ RESIDUE CHEMISTRY: 509-8547 ■ LABORATORY ACCESSION LABEL yy RADIATION: 509-8526 TOWN NUMBER: .2 L _J S06074J'SC1UT COLLECTOR'S INFORMATION 1540 SULLIVAN AVE DATE COLLECTED: TIME COLL.(00:00-24:00): TOWN HALL SOUTH WIND' I;R 9 CT 0607 SAMPLE INFORMATION COLLECTOR'S SAMPLE#: NAME OF UTILITY OR PROPERTY OWNER: COLLECTED BY(LAST NAME,FIRST NAME): lo ihT)l IL' I y S 'e. SOURCE: I-DI& Inkh ld d H (k r Eli, ld-c COLLECTOR'S TITLE: ADDRESS(OF SAMPLE COLLECTION): ldhl\/l skl ld 11 F3141 IDlelmlikIll Ifld COLLECTOR'S PHONE#: TOWN OF SAMPLE COLLECTION): STATE: U.MMM ADDI ONAL INFORMATION: COMPLAINTS RE UESTS TREATMENTS ETC. : ZIIP�CODE: Fm V o < -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 CARBAMOYLOMMES ❑92OR 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 ❑ 1820 EPA 552.1 HALOACETIC ACIDS and DALAPON ❑ 155R EPA 902.0 IODINE 131 ❑ OTHER ❑511 R EPA 906.0 TRITIUM ❑ 504R EPA 901.1 GAMMA ❑ OTHER OL-91C REV.10/98 ■