ABCDEFGHIJKLMNOPQRSTUVWXYZAAABACADAEAFAGAHAIAJ
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1/4/2024
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Biosolids-PFAS data reporting sheet
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Only fill in columns with Blue headers.
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Yellow row is an example row.
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Example Row:
Cheyenne WWTF111-5A-202301/19/2023 = 20230119280-171905-1Draft 1633Perfluorobutanoic acid (PFBA)375-22-415.6Jug/Kg472.2CO000006N 37.2688W -105.9283Eurofins Denverbiosolids2/13/2023 = 2023021318.2John Doe970-000-1212
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CDPHE Sample Number
(assigned by Database)		Site ID
(assign by HDR - Leave blank)		PWSID (Leave blank)
PWS System Name (Leave Blank)
Facility Name
(Preparer/ Facility Name)		Sample Location Description (biosolids don't need)Facility Type (biosolids don't need)Source Water Type

PWS Sample Location Type (Biosolids don't need)Treatment Status (biosolids don't need)
(finished or unfinished)		Notes on Upstream Treatment Type(s) (biosolids don't need)
Client Sample IDSample Date
(YearMoDay)		Lab Sample ID (Lab LotID)Analysis/Lab MethodsComponent (Analyte)CAS NumberResultFinal QualifierUnitsRLMDLSample Type (biosolids don't need)Sampled by?DWR Well Permit ID
NPDES Permit ID
( Permit # or Other)		Sample Location Street Address (Don't need biosolids)LatitiudeLongitudeLabNameCommentsMatrix (item sampled)Analysis Date% SolidsContact Personcontact phone # or email
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