Drinking Water Sample Submission Form

Have you had your water tested by us before? Yes No Most Recent Year: __________

. . . .

Your name and contact information: Name: ________________________________________________________________________ (Individual who sampled water)

For CFCC Faculty / Staff Only:

Sample Number: ____________ Analyst: __________________

Address: ______________________________________________________________________

Date Acptd: _______________ Time Acptd: ________ AM PM

City:______________________________________State:____________ Zip: _____________

 GCMS  IC Telephone: ______________________________ Fax: _______________________________  TOC  AA  pH Email: _______________________________________________________________________ o Your report will be emailed or faxed. If you do not have an email address or fax number,  TDS/Residue  Hardness

please discuss delivery options with a Chemical Technology faculty or staff member.

__________ __________ __________ __________ __________ __________ __________

Sample Information AM

Sample identification: ______________________________________ Date sampled: _______________ Time sampled: __________ PM (Identification for your own use to be printed on report) (Date and time sampled must be completed) County location (if NC): ____________________________________ Please specify if your water is raw (untreated) or treated with any of the following (check all that apply): o Untreated o Water softener o Disinfection o Carbon filter o UV treated o Iron filter o Acid neutralization o Other (please specify): ______________________________________

o Reverse osmosis (RO) filter

If you are submitting your water sample because of a specific concern, please specify (check all that apply): o No specific concern o Cloudiness o Bad taste or odor o Staining o Health concern o Nearby land use o Other (please specify): ______________________________________________________________________________________ If your water source is located in sight of any of the following activities, please specify (check all that apply): o Mining o Gas/oil well o Agriculture o Industry o Road o Housing development o Other: _______________________

Analysis Request (See back of this form for test descriptions) TEST PACKAGES (Check

o DW01

all that apply) Anion Panel

Performed All Year

2-3 Business Days

o DW02

Metals Panel

Performed All Year

5-7 Business Days

o DW03

Organic Panel

Performed Only Sept - Nov

5-7 Business Days

o DW04

Total Organic Carbon

Performed All Year

1-2 Business Days

o DW05

pH, TDS, Residue and Hardness

Performed All Year

1-2 Business Days

Chemical Technology Analytical Services Laboratory • Cape Fear Community College Department of Engineering Wilmington, NC 28401 • Phone: 910-362-7168 • Email: [email protected]

Drinking Water Tests Limit

Test

Importance/Sources

Aluminum

Causes metallic-tasting water. Sources: some naturally occurring, but most from mining activities

0.050

Antimony

Found in batteries, pigments, discharged from petroleum refineries, fire retardants, and electronics. May cause increased levels of blood cholesterol.

0.006

Barium

May cause hypertension and other health effects. Sources: mostly from deep brines from gas/oil well drilling; may also occur from industrial activities

2.000

Bromide

Has a low degree of toxicity and can be used in drinking water as a disinfectant. Commonly found in seawater, saltwater lakes, and underground brines.

NA

Cadmium

Used for metal plating and coating, machinery, photography, and television phosphors. Commonly found in nickel-cadmium (NiCad) batteries. Long term exposure shows kidney damage.

0.005

Chloride

Causes salty tasting water; corrosion and blackening of steel. Sources: some naturally occurring, but primarily from gas/oil well drilling brines or road salt

250.0

Chromium

Chromium is found naturally in rocks, plants, soil, volcanic dust, humans, and animals. Chromium is used for chrome plating, dyes, pigments, leather, and wood preservation. Some people who use water containing chromium in excess of the limit could experience allergic dermatitis. Causes blue-green stains; bitter metallic-tasting water; gastrointestinal upset; liver and kidney damage. Sources: most from corrosion of copper plumbing; more rarely from industrial waste sites

0.100

May cause bone damage and discoloration of teeth. Sources: naturally occurring; present in some industrial wastes Causes whitish-gray residue when water is heated; decreased life of water heater elements; increased use of soap. Sources: naturally occurring in many areas, especially where limestone occurs May cause orange, brown stains; metallic-tasting water. Source: naturally occurring or from mining activities Many serious health effects. Often found in association with copper. Primary source: metal plumbing; more rarely from industrial wastes sites

4.000

Copper Fluoride Hardness

Iron Lead Magnesium

Manganese

Nickel

Nitrate

Nitrite

pH

Phosphate Silver

Third most abundant element dissolved in seawater. Many bottled waters contain little or no magnesium. Tap water normally shows very low levels. Magnesium is crucial to the body and helps control heart rhythms, controls blood pressure, helps maintain insulin and regulates over 300 enzymes. Causes black stains; gives water metallic taste. Less toxic than nickel or copper. High exposure has been linked to impaired motor skills and cognitive disorders. Sources: naturally occurring or from mining activities Necessary in diets but can become carcinogenic and toxic in high doses. Women are more allergic to nickel exposure than men. The primary source of nickel in drinking water is leaching from metals such as pipes and fittings. Groundwaters can contain nickel as a consequence of nickel ore-bearing rocks. Runoff from fertilizer use, leaking from septic tanks, sewage, and erosion of natural deposits. Infants below the age of six months who drink water containing nitrate could become seriously ill and, if untreated, may die. Symptoms include shortness of breath and blue-baby syndrome. Runoff from fertilizer use, leaking from septic tanks, sewage, and erosion of natural deposits. Infants bellows the age of six months who drink water containing nitrite could become seriously ill and, if untreated, may die. Symptoms include shortness of breath and blue-baby syndrome. When low, causes bitter, metallic taste; corrosion and leaks in metal pipes. When high, causes slippery feeling water with soda taste and leads to scale deposits. Sources: naturally controlled, but may be impacted by mining activities Not toxic to people or animals unless present in very high levels. Digestive problems could occur from extremely high levels. Not a dietary requirement. A person has a natural daily intake of silver daily. Normal amounts are not health threatening. Silver is a bactericide and may be used in water disinfection. Excess silver can end up deposited in connective tissue, skin and eyes, and can cause a gray to black coloring.

1.000

NA 0.300 0.000 NA

0.500 NA 10.000 1.000 6.5-7.5 NA 0.050

Sulfate

Causes bitter medicinal-tasting water; laxative effect. Sources: naturally occurring; mining activities

Zinc

An essential mineral. Excess zinc can cause growth retardation, delayed sexual maturation, diarrhea, and contributes to the death of 800,000 children worldwide per year. Causes cloudy and/or bad-tasting water, hardness, and staining. Sources: naturally occurring, but may be caused by any land-use changes

Total Dissolved Solids

250.0 5.000 500.0

Drinking Water Test Packages ID

Package

Description

Tests Includes

Available

DW01

Anion

Fluoride, chloride, bromide, nitrate, nitrite, phosphate, and sulfate.

Fall & Spring

DW02

Metal

Basic tests for which drinking water samples should be routinely tested. Includes primary, secondary, and non-regulated contaminants. Available throughout the academic year. Basic tests for which drinking water samples should be routinely tested. Available throughout the academic year.

Fall & Spring

DW03

Organics

Advanced test for drinking water quality that focuses on trace levels of contamination.

Aluminum, antimony, barium, cadmium, chromium, cobalt, copper, iron, lead, magnesium, manganese, nickel, silver, and zinc Tests includes information on over 40 organic compounds (not listed above).

DW04

TOC

A basic test that provides an overall “quality” of a water sample. Does not provide information on specifics.

Total Organic Carbon

Fall, Spring, & Summer

DW05

pH, residue, TDS

A series of basic tests that provides information on acidity and/or alkalinity and total amount of solids dissolved in a water sample and water hardness.

pH, residue, TDS (total dissolved solids), water hardness

Fall, Spring, & Summer

Fall Only

* If you are performing this test for the purpose of documenting water quality before and/or after gas-drilling activities, it is recommended that you use an accredited laboratory that can collect your sample and provide full chain of custody.

For additional information, visit www.cfcc.edu/engineering/chemical-technology or contact the lab.