1111? SystemiD

10/30/2006 Sample date

L/ "j';) 7 ADEQ Project Number

,NEW SYSTEM NEWP.O.E.

Gary Larsen

YES YES

Owner I Contact Person Name

{480) 987-3842

Owner I Contact Fax Number

SAMPLE TYPE ~Compliance Monitoring

ARIZONA DEPARTMENT OF ENVIRONMENTAL QUALITY DRINKING WATER SOURCE APPROVAL FORM

SAMPLES TO BE TAKEN AT SOURCE ONLY

Johnson Utilities Co., LLC

NO NO

System Name

__.12_:0_0~-:--- (24 hr clock) Sample time

65-212512

Well ID Number

Surface Water Intake ID Number

(480) 797-2660 Owner I Contact Person Phone Number

Anthem Well #4 (55-212512)

SAMPLING SITE ID

SAMPLE COLLECTION POlNTIID 0 Point of Entry #

This fonn is intended to be completely fiUed out and ALL pages submitted together for all microbiological and chemical tests detailed on this fonn, Jf more than one laboratory participated in the analysis, please attach a copy of the original laboratory report, signed by the performing laboratory, to the back of this fonn.

ALL RESULTS SHALL BE REPORTED IN MILLIGRAMS PER LITER (mg/L) UNLESS OTHERWISE SPECIFIED.

Please note: The A;rsenic MCL is current(y 0.05 mg/L. However, on JM. 23, 2006, the Arsenic MCL will be 0. OJ mg/L.

PLEASE MAIL THIS COMPLETED FORM TO:

ARIZONA DEPARTMENT OF ENVIRONMENTAL QUALITY TECHNICAL REVIEW UNIT

DRINKING WATER SECTION (5415B-2) 1110 W . Washington St.

Phoenix, AZ 85007

SWVP-011288

***Inorganic Chemical Analysis***

Analysis MCL Reporting Contaminant Cont. Analysis Result 1ethod Limit Name Code Run Date

EPA200.9 0.01 O.o1 Arsenic 1005 11/13/2006 11:39 0.002 EPA200.7 2 2 Barium 101 0 11106/2006 14:09 0.02

EPA200.9 0.005 0.005 Cadmium 1016 11/13/2006 11:39 <0.0002 EPA200.7 0.1 0.1 Chromium 1020 11/06/2006 14:09 0.014

EPA200.7 1.3* 0.050 Copper 1 022 11/06/2006 14:09 0.028

SM 4500 FC 4.0 2.0 Fluoride 1025 11/07/2006 17:11 0.70

EPA200.9 0.016* 0.0025 Lead :1030 11/13/2006 11:39 0.003 EPA245.1 0.002 0.002 Mercury 1035 11/03/2006 17:00 <0.0002 Calculation 10 5 Nitrate (as N) 1040 ·11/01/2006 14:27 1.65

SM 4500 N02 B 1 0.6 Nitrite 1 041 10/3012006 16:43 <0.10 EPA200.9 0.05 0.05 Selenium 1046 11/13/2006 11 :39 <0.002 EPA 200.9 . 0.006 0.006 Antimony 1074 11/20/2006 16:46 <0.004 EPA200.7 0.004 0.004 Beryllium 1075 11106/2006 14:09 <0.002 SM4500CN E 0.2 0.2 Cyanide (as free cyanide) 1024 11/07/2006 8:00 <0.010 EPA200.7 0.1 0.1 Nickel 1 036 11/06/2006 14:09 <0.02 EPA200.9 0,002 0.002 Thallium 1 085 11/1412006 8:08 <0.001

LABORATORY INFORMATION Specimen Number: 6101738·01

Lab ID Number: AZ0004 l;omments:

uthorized Signature:

* Action Level

· ***Physical Anlllysls***

Analysis Method

MCL Reporting Contaminant Cont. Code

Analysis Run Date Limit Name

EPA 300.0

EPA200.7 SM4500H 8

SM 23208 SM23408 Miscellaneous SM2540D

Specimen Number: 6101738-01

Sulfate Sodium

pH Alkalinity

1 055 11/0212006 13:52 1052 11106/2006 14:09 1926 1 0/S0/2006 16:00 1927 11/01/2006 14:31

Hardness/Calcium 1918 11/06/2006 14:09 Langelier Index 1997 11/14/2006 17:05

Total Dissolved Solfds-TDS 1930 11/02/2006 8:11

· LABORATORY INFORMATION

Lab lD Number: AZ0004 ~ Name~· gend Technical Services of Arizona Comments: • '1:f1 ~ · Authorized Signalute: ~ !(J'CM;t

DWAR 9: R!)vised 2004 Page2 of S

Exceeds MCL

D D

0 D 0 D

0 D D

D D

D

D

0

D D

Exceeds Reporting Limit

D D 0

-0 0 D ~

0

D D 0

0

0 0

D 0

Result

72.8

112

8.0

124 160 0.137 468

SWVP-011289

[" ..... . ... ....

**'~'Synthetic Organic Chemical Analysis*** ! )

! Analysis MCL Reporting Contaminant Cont. Analysis Result Exceeds Exceeds 'liethod Limit Name Code Run Date MCL Reporting Limit

EPA515.3 0.07 0.0001 2,4-D 2105 11/07/2006 0:00 <0.0001 0 0

EPA515.3 0.05 0.0002 2,4,5-TP (SIIvex) 2110 11/07/2006 0:00 <0.0002 [] 0 EPA525.2 0.002 0.0002 Alachlor 2051 11/03/2006 0:00 <0.0002 0 0

EPA505 0.003 0.001 Toxaphene 2.020 11/08/2006 0:48 <0.0010 0 D

EPA525.2 0.003 0.0001 Atrazine 2050 11/03/2006 0:00 <0.0001 0 []

EPA531.1 0.04 0.0009 Carbofuran 2046 10/31/2006 16:17 <0.000900 0 0

EPA615.3 0.001 0.00004 Pentachlorophenol 2326 11/07/2006 0:00 <0.00004 0 0

EPA505 0.002 0.0002 Chlordane 2959 11/08/2006 0:48 <0.00020 0 0

EPAS04.1 0.0002 0,00002 Dlbromochloropropane 2931 11/09/2006 0:00 <0.00002 0 0 (DBCP)

EPA 504.1 0.00005 0.00001 Ethylene Dibromlda (EDB) 2946 11/09/2006 0:00 <0.00001 0 0

EPA525.2 0.0004 0.00004 Heptachlor 2065 11/03{2006 0:00 <0.00004 0 []

EPA525.2 0.0002 0.00002 Heptachlor Epoxide 2067 11/03/2006 0:00 <0.00002 [] D

EPA525.2 0.0002 0.00002 lindane 201 0 11/03/2006 0:00 .<0.00002 0 0

EPA626.2 0.04 0.0001 Methoxychlor 2016 11/03/2.006 0!00 <0.0001 D 0

EPA525.2 0.0002. 0.00002 Benzo (a) Pyrene 2306 11/03/2006 0:00 <0.00002 D 0

EPA515.3 0.2 0.001 Dalapon 2031 11/07/2006 0:00 <0.001 0 0 EPA62.5.2 0.006 0.0006 01(2-ethylhexyl)phthalate 2039 11/03/2006 0:00 <0.0006 0 0

t EPA525.2 0.4 0.0006 Dl(2-ethylhexyl)adipate 2035 11/03/2006 0:00 <().0006 0 0 i EPA515.3 0.007 0.0002 Dlnoseb 2041 11/07/2006 0:00 <0.0002 D 0 ! -:JA 16138 3 X 10(-8)5 X 10(-9)2,3,7,8-TCDD (Dioxin) 2063 11/07/2006 0:00 <0.000000005 0 0

EPA549.2 0.02 0.0004 Diquat 2032 11/02/2006 0:00 <0.0004 0 0 EPA548.1 0.1 0,009 Endothall 2033 11/02/2006 0:00 <0.009 0 0

EPA 526.2 0.002 0.00001 Endrin 2005 11/03/2006 0:00 <0.00001 0 0

EPA547 0.7 0.006 Glyphosate 2034 11/06/2006 0:00 <0.006 0 0

EPA 626.2 0.001 0.0001 Hexachlorobenzene 2274 11/03/2006 0:00 <0.0001 0 0

EPA625.2 0.05 0.0001 Hexachlorocyclopentad!ene 2042 11/03/2006 0:00 <0.0001 0 []

EPA531.1 0.2 0.002 Oxamyl 2036 10/31/2006 15:17 <0.00200 0 0 EPA515.3 0.5 0.0001 Picloram 2040 11/07/2006 0:00 <0.0001 0 0

EPA526.2 0.004 0.00007 S!mazlne 2037 11/03/2006 0:00 <0.00007 D 0

LABORATORY INFORMATION Specimen Number: 6101738-01

Lab ID Number; AZ0004 Name: Legend Technical Services of Arizona

CommentS: · ~ • ~ t}1 ~ l Authorized Signature: :V4f ZLl f/IL.J1a Aroclor Results may be submitted in lieu of PCB Method 505 analyzed by Legend Technical Services, Inc., St. Paul, MN, #AZ0557 Methods 504, 515, 525, 531, 547, 548 and 549 analyzed by Underwriters Laboratories, South Bend IN, #AZ0432. Method 1613 (Dioxin) performed by Pace Analyti~J Services, Minn. MN #AZ0014

DW AR 9: Revised 2004 Page3 of 5

SWVP-011290

***Aroclor (PCB Screening Test)***

Analysis MCL Reporting Contaminant Cont. Analysis Result Exceeds \<fethod Limit Name Code Run Date Reporting Limit

EPA605 0.00008 Aroclor 1016 2388 11/08/2006 0:48 ..;0.000080 0

EPA605 0.02 Aroclor 1221 2390 11/08/2006 0:48 <(),020 0

EPA505 0.0005 Aroclor 1232 2392 11/08/2006 0:48 <0.00050 0

EPA505 · . 0.0003 Aroclor 1242 2394 11/08/2006 0:48 <0.00030 0

EPA605 0.0001 Aroclor 1248 2396 11/08/2006 0:48 <0.00010 0

EPA505 0.0001 Aroclor 1254 2398 11/08/2006 0:48 <0.00010 0

EPA605 0.0002 Aroclor 1260 2400 11/08/2006 0:48 <0.00020 0

LABORATORY INFORMATION Specimen Number: 6101738·01

Lab ID Number: AZ0004 Narrie: Legend Technical Services of Arizona Comments: ~ 4fatJw.la<hC( Authorized Signature:

•••Volatile Organic Chemical Analysis*"'*

-Analysis MCL Reporting Contaminant Cont. Analysis Result Exceeds Exceeds Method Limit Name Code Run Date MCL Reporting Limit

EPA524.2 0.007 0.0005 1,1-Dichloroethylene 2977 11/02/2006 18:64 <0 .0005 0 0

EPA524.2 0.2 0.0005 1 , 1,1· T rlchloroethane 2981 11/02/2006 18:54 <0.0005 0 0

EPA524.2 0.005 0.0005 1,1 ,2-Trichloroethane 2985 11/02/2006 18:54 <0.0005 0 0

EPA524.2 0.005 0.0005 1, 2-Dichloroethane 2980 11/02/2006 18:54 <0.0005 0 0

">A524.2 0.005 0.0005 1,2-Dichloropropane 2983 11/02/2006 18:64 <0.0005 0 0

EPA524.2 0.005 0.0005 Benzene 2990 11/02/2006 18:64 <0.0005 0 0

EPA624.2 0.005 0.0005 Carbon Tetrachloride 2982 11/02/2006 18:64 <(l.0005 0 0

EPA524.2 0.07 0.0005 cis-1,2-Dichloroethylene 2380 11/02/2006 18:54 <0.0005 0 D

EPA524.2 0.7 0.0005 Ethylbenzene 2992 11/02/2006 18:54 <0.0005 0 0

EPA524.2 0.1 0.0005 (mono) Chlorobenzene 2989 11/02/2006 18:64 <().0005 0 0

EPA624.2 0.6 0.0005 a-Dichlorobenzene 2968 11/02/2006 18:54 <0.0005 0 0

EPA524.2 0.075 0.0005 para-Dichlorobenzene 2969 11/02/2006 18:54 <0.0005 0 0

EPA524.2 0.1 0.0005 Styrene 2996 11/02/2006 18:64 <0.0005 0 0

EPA524.2 0.005 0.0005 Tetrachloroethylene 2987 11/02/2006 18:54 <0.0005 0 0

EPA524.2 1 0.0005 Toluene . 2991 11/02/2006 18:54 <0.0005 0 0

EPA524:2 0.1 0.0005 Trans-1,2-Dichloroethylene 2979 11/02/2006 18i54 <0.0005 0 0

~PA524.2 .0.005 0.0005 Trichloroethylene 2984 11/02/2006 18:54 <0.0005 0 ·o EPA524.2 0.002 0.0005 Vinyl Chloride 2976 11/02/2006 18:54 <0.0005 0 0 EPA 524.;2,; 10 0.0015 Xylenes, Total 2955 11 {02/2006 18:64 <0.0015 0 0

EPA524.2 0.07 0.0005 1,2,4-Trichlorobenzene 2378 11/0212006 18:54 <0.0005 0 0

EPA524.2 0.005 0.0005 Dichloromethane 2964 11/02/2006 1 8:64 <0.0005 0 0

LABORATORY INFORMATION Specimen Nl}mber: 6101738·01

Lab ID Number: AZ0004 Comments:

1thorized Signature:

DW AR 9: Revised 2004 Page4of5

SWVP-011291

•**Radiochemical Analysis***

Analysis \fethod

MCL Reporting Contaminant Cont. Code

Analysis · Run Dale

Result Exceeds Exceeds Limit Name MCL Reporting Limit

t:PA 600/00-02 3 pCI/L Gross Alpha 4002 ND

LABORATORY INFORMATION Specimen Number: 6101738-01

Lab ID Number: AZ0004 Name: Legend Technical Services of Arizona

Commen~:~--------~~~~r.r.~~~~~~--~---,r------------------------­Authorlzed Signature: -f-.{7A/ ~.,..~bf·~,&y.,~l?f..:r::l.,q.lj-w-:J~~n.)M>;;;(9----------

[J 0

* Gross alpha is the value of all alpha particle emitters except for uranium and radon 222. Radium 226 is included in the reported gross alpha value. All units are reported in picocuries per liter (pCill) EXCEPT for gross beta which is reported in millirem per year.

** These values are assumed to produce a total body or organ dose of 4 millirem per year.

Radiochemistry perfonned by Radiation Safety, Chandler AZ #AZ0462.

***&bestos Analysis*•*

Analysis Method

MCL Reporting Contaminant Limit Name

Cont. Code

Analysis Run Date

Result Exceeds MCL

EPA 100.1 7MFL

Specimen Number: 6101738-01

Asbestos 1094 11/06/2006 0:00 <4 .. 9

LABORATORY INFORMATION

Lab lD Number: AZ0004 Comments: Authorized c;:Si'-g~na::;tu:::re:=·::--lf7~f,e~~'T.r.t'l:pjjtfl~~r-------------------

.sbestos perfonned by Fiberquant, Phoenix AZ #AZ0904

Analysis Method

MCL Contaminant Name

***Microbiological Analysis***

Cont. Code

Test Start Date/fime

Analysis Run Datefl'ime

0

SM9223B · Present I 1 ormore Coliform

Total Coliform 3000 10/30/06 4:18:00PM 10/30/06 4:18:00PM

LABORATORY INFORMATION Specimen Number: 6101738·01

Lab ID Number: AZ0004 ices of Arizona

Comments:~· -----~~~~~~~~~~~~~------------------------­Authorized Signature: ---:oo::-.J'-------------=---------------------.----,-

ONLY REPORT FECAL RESULT IF TOTAL COLIFORM RESULT IS POSITIVE

Analysis Method

SM9223B

MCL

Present I 1 or more Coliform

"'">ecimen Number: 6101738·01

Contaminant Name

E. Coli or Fecal Coliform

Cont. Code

Test Start Date!flme

·Analysis Run Datefl'ime

3013 10/30/06 4:18:00PM 10/30/06 4:18:00PM

LABORATORY INFORMATION

~ab ID Number: AZ0004

Comments:~-------,~~~~~~~7n~~~~---------------------­Aulhorized Signature: -""""'.c..:jf-¥.~~~0do.!:...ld~~<.Saa...!~------------------------

DW AR 9: Revised 2004 PageS of 5

Result

Absent

Result

Absent

SWVP-011292