Contoh Laporan No 5 Tahun 2014 (Lampiran XLVII)

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Attachments-1 : CRT-/SIMED-XI/MFS/2020

LABORATORY ANALYSIS REPORT

Customer :
Address :
Sample Taken :
:
Sample Received :
Date Of Analysis :
Sample Matrix :
GPS Coordinate N E

STANDARD
NO PARAMETER UNIT RESULT METHOD
GOLONGAN I GOLONGAN II
I. Physical Properties
1 Temperature o
C 38 40 SNI 06-6989.23:2005
2 Total Dissolved Solid, TDS mg/l 2,000 4,000 IKA-LL-SIMED-022 (Electrode)
3 Total Suspended Solid, TSS mg/l 200 400 SNI 6989.3:2019
II. Chemical Properties
1 pH pH Units 6.0-9.0 6.0-9.0 SNI 6989.11:2019
2 Biochemical Oxygen Demand, BOD5 mg/l 50 150 IKA-LL-SIMED-019 (OXITOP IS 6)
3 Chemical Oxygen Demand, COD mg/l 100 300 SNI 6989.2:2019
4 Iron, Fe mg/l 5 10 APHA 23rd ed.3120 B, 2017
5 Manganese, Mn mg/l 2 5 APHA 23rd ed.3120 B, 2017
6 Barium, Ba mg/l 2 3 APHA 23rd ed.3120 B, 2017
7 Copper, Cu mg/l 2 3 APHA 23rd ed.3120 B, 2017
8 Zinc, Zn mg/l 5 10 APHA 23rd ed.3120 B, 2017
9 Hexavalent Chromium, Cr6+ mg/l 0.1 0.5 IKM-LL-SIMED-005 (Spectrophotometry)
10 Chrome, Cr mg/l 0.5 1 APHA 23rd ed.3120 B, 2017
11 Cadmium, Cd mg/l 0.05 0.1 APHA 23rd ed.3120 B, 2017
12 Mercury, Hg mg/l 0.002 0.005 APHA 23rd ed.3120 B, 2017
13 Lead, Pb mg/l 0.1 1 APHA 23rd ed.3120 B, 2017
14 Stannum, Sn mg/l 2 3 APHA 23rd ed.3120 B, 2017
15 Arsenic, As mg/l 0.1 0.5 APHA 23rd ed.3120 B, 2017
16 Selenium, Se mg/l 0.05 0.5 APHA 23rd ed.3120 B, 2017
17 Nickel, Ni mg/l 0.2 0.5 APHA 23rd ed.3120 B, 2017
18 Cobalt, Co mg/l 0.4 0.6 APHA 23rd ed.3120 B, 2017
19 Cyanide, CN mg/l 0.05 0.5 IKM-LL-SIMED-016 (Spectrophotometry)
20 Hydrogen Sulfida, H2S mg/l 0.5 1 IKM-LL-SIMED-014 (Spectrophotometry)
21 Fluoride, F mg/l 2 3 APHA 4500-F-E
22 Free Chlorine, Cl2 mg/l 1 2 IKM-LL-SIMED-018 (Spectrophotometry)
23 Total Ammonia, NH3-N mg/l 5 10 IKM-LL-SIMED-012 (Spectrophotometry)
Nitrate, NO3-N
24 mg/l 20 30 IKM-LL-SIMED-004 (Spectrophotometry)
25 Nitrite, NO2-N mg/l 1 3 IKM-LL-SIMED-017 (Spectrophotometry)
26 Nitrogen Total mg/l 30 60 DIN EN ISO 11905-1
27 Methylen Blue mg/l 5 10 SNI 06-6989.51:2005
28 Phenol mg/l 0.5 1 APHA 5530 C+D:2012
29 Oil and Grease mg/l 10 20 SNI 6989.10:2011
30 Total Coliform MPN/100 ml 10,000 Membrane Filter
Based on Ministry of Environmental Regulation No. 5 year 2014, attachment XLVII
Method of Sampling SNI 6989.59:2008
Weather during of sampling : Sunny
The Result relate only to the samples tested and report shall not be reproduced except full,
without written approval of the laboratory

page 1 of attch.1
LABORATORIUM PENGUJIAN No. Dok FPP-LAB-SIMED-018-04
PT. SURVEYOR INDONESIA CABANG MEDAN No. Revisi 00
Tgl. Terbit 25 Juni 2019
DRAFT REPORT OF ANALYSIS LINGKUNGAN
Halaman

Attachments-1 : CRT-/SIMED-XI/MFS/2020

LABORATORY ANALYSIS REPORT

Customer :
Address :
Sample Taken :
:
Sample Received :
Date Of Analysis :
Sample Matrix :
GPS Coordinate N E

STANDARD
NO PARAMETER UNIT RESULT METHOD
GOLONGAN IGOLONGAN II
I. Physical Properties
1 Temperature o
C 38 40 SNI 06-6989.23:2005
2 Total Dissolved Solid, TDS mg/l 2,000 4,000 IKA-LL-SIMED-022 (Electrode)
3 Total Suspended Solid, TSS mg/l 200 400 SNI 6989.3:2019
II. Chemical Properties
1 pH pH Units 6.0-9.0 6.0-9.0 SNI 6989.11:2019
2 Biochemical Oxygen Demand, BOD5 mg/l 50 150 IKA-LL-SIMED-019 (OXITOP IS 6)
3 Chemical Oxygen Demand, COD mg/l 100 300 SNI 6989.2:2019
4 Iron, Fe mg/l 5 10 APHA 23rd ed.3120 B, 2017
5 Manganese, Mn mg/l 2 5 APHA 23rd ed.3120 B, 2017
6 Barium, Ba mg/l 2 3 APHA 23rd ed.3120 B, 2017
7 Copper, Cu mg/l 2 3 APHA 23rd ed.3120 B, 2017
8 Zinc, Zn mg/l 5 10 APHA 23rd ed.3120 B, 2017
9 Hexavalent Chromium, Cr6+ mg/l 0.1 0.5 IKM-LL-SIMED-005 (Spectrophotometry)
10 Chrome, Cr mg/l 0.5 1 APHA 23rd ed.3120 B, 2017
11 Cadmium, Cd mg/l 0.05 0.1 APHA 23rd ed.3120 B, 2017
12 Mercury, Hg mg/l 0.002 0.005 APHA 23rd ed.3120 B, 2017
13 Lead, Pb mg/l 0.1 1 APHA 23rd ed.3120 B, 2017
14 Stannum, Sn mg/l 2 3 APHA 23rd ed.3120 B, 2017
15 Arsenic, As mg/l 0.1 0.5 APHA 23rd ed.3120 B, 2017
16 Selenium, Se mg/l 0.05 0.5 APHA 23rd ed.3120 B, 2017
17 Nickel, Ni mg/l 0.2 0.5 APHA 23rd ed.3120 B, 2017
18 Cobalt, Co mg/l 0.4 0.6 APHA 23rd ed.3120 B, 2017
19 Cyanide, CN mg/l 0.05 0.5 IKM-LL-SIMED-016 (Spectrophotometry)
20 Hydrogen Sulfida, H2S mg/l 0.5 1 IKM-LL-SIMED-014 (Spectrophotometry)
21 Fluoride, F mg/l 2 3 APHA 4500-F-E
22 Free Chlorine, Cl2 mg/l 1 2 IKM-LL-SIMED-018 (Spectrophotometry)
23 Total Ammonia, NH3-N mg/l 5 10 IKM-LL-SIMED-012 (Spectrophotometry)
Nitrate, NO3-N
24 mg/l 20 30 IKM-LL-SIMED-004 (Spectrophotometry)
25 Nitrite, NO2-N mg/l 1 3 IKM-LL-SIMED-017 (Spectrophotometry)
26 Nitrogen Total mg/l 30 60 DIN EN ISO 11905-1
27 Methylen Blue mg/l 5 10 SNI 06-6989.51:2005
28 Phenol mg/l 0.5 1 APHA 5530 C+D:2012
29 Oil and Grease mg/l 10 20 SNI 6989.10:2011
30 Total Coliform MPN/100 ml 10,000 Membrane Filter
Based on Ministry of Environmental Regulation No. 5 year 2014, attachment XLVII
Method of Sampling SNI 6989.59:2008
Weather during of sampling : Sunny
The Result relate only to the samples tested and report shall not be reproduced except full,
without written approval of the laboratory

page 1 of attch 1

LABORATORIUM LINGKUNGAN SURVEYOR INDONESIA


Jl. Sunggal No.197, Medan 20122
Tel : (061) 42569565, Fax : (061) 42569564

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