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 : PT. AAA

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

NO PARAMETER UNIT STANDARD RESULT METHOD

I. Physical Properties
1 Turbidity NTU 25 1 SNI 06-6989.25-2005
2 Colour TCU 50 2 Spectrophotometry
3 Total Dissolved Solid, TDS mg/l 1000 3 IKA-LL-SIMED-022 (Electrode)
4 Temperature o
C Air Temperature ± 3 4 SNI 06-6989.23:2005
5 Taste No Taste 5 Organoleptic
6 Smell No smell 6 Organoleptic
II. Chemical Properties
1 pH mg/l 6.5 - 8.5 7 SNI 6989.11:2019
2 Iron, Fe mg/l 1 8 APHA 23rd ed.3120 B, 2017
3 Fluoride, F mg/l 1.5 9 APHA 4500-F-E
4 Total Hardness, CaCO3 mg/l 500 10 SNI 06-6989.12-2004
5 Manganese, Mn mg/l 0.5 11 APHA 23rd ed.3120 B, 2017
6 Nitrate, NO3 - N mg/l 10 12 IKM-LL-SIMED-004 (Spectrophotometry)
7 Nitrite, NO2 - N mg/l 1 13 IKM-LL-SIMED-017 (Spectrophotometry)
8 Cyanide, CN mg/l 0.1 14 IKM-LL-SIMED-016 (Spectrophotometry)
9 Surfactants, MBAS mg/l 0.05 15 SNI 06-6989.51:2005
10 Total Pesticides mg/l 0.1 16 Gas Chromatography
III. Biology Properties
1 Total Coliform CFU/100 ml 50 17 Membrane Filter
2 E.Coli CFU/100 ml 0 18 Membrane Filter
Based on Govermment Regulation No. 32 year 2017
Method of Sampling SNI 6989.58:2008
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 attch 1

LABORATORIUM LINGKUNGAN SURVEYOR INDONESIA

 Jl. Sunggal No.197, Medan 20122
Tel : (061) 42569565, Fax : (061) 42569564
 Attachments-1 : CRT-/SIMED-XI/MFS/2020

LABORATORY ANALYSIS REPORT

Customer : PT. AAA

Address : BBB
Sample Taken :-
:
Sample Receive : -
Date Of Analysis: -
Sample Matrix : -
GPS Coordinate N E
- -

NO PARAMETER UNIT STANDARD RESULT METHOD

I. Physical Properties
1 Turbidity NTU 25 1 SNI 06-6989.25-2005
2 Colour TCU 50 2 Spectrophotometry
3 Total Dissolved Solid, TDS mg/l 1000 3 IKA-LL-SIMED-022 (Electrode)
4 Temperature o
C Air Temperature ± 3 4 SNI 06-6989.23:2005
5 Taste No Taste 5 Organoleptic
6 Smell No smell 6 Organoleptic
II. Chemical Properties
1 pH mg/l 6.5 - 8.5 7 SNI 6989.11:2019
2 Iron, Fe mg/l 1 8 APHA 23rd ed.3120 B, 2017
3 Fluoride, F mg/l 1.5 9 APHA 4500-F-E
4 Total Hardness, CaCO3 mg/l 500 10 SNI 06-6989.12-2004
5 Manganese, Mn mg/l 0.5 11 APHA 23rd ed.3120 B, 2017
6 Nitrate, NO3 - N mg/l 10 12 IKM-LL-SIMED-004 (Spectrophotometry)
7 Nitrite, NO2 - N mg/l 1 13 IKM-LL-SIMED-017 (Spectrophotometry)
8 Cyanide, CN mg/l 0.1 14 IKM-LL-SIMED-016 (Spectrophotometry)
9 Surfactants, MBAS mg/l 0.05 15 SNI 06-6989.51:2005
10 Total Pesticides mg/l 0.1 16 Gas Chromatography
III. Biology Properties
1 Total Coliform CFU/100 ml 50 17 Membrane Filter
2 E.Coli CFU/100 ml 0 18 Membrane Filter
Based on Govermment Regulation No. 32 year 2017
Method of Sampling SNI 6989.58:2008
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