ST0701-LR100129vvater uacterioiogy Keport / unalin OT custoav Kecord
City of Lewisville Environmental Control Services Laboratory S amples Accepted Customer Comments Report #
I EANISVIL E 897 Treatment Plant Rd., Lewisville, TX 75057 Monday - Thursday � t
„.eadmaxr..� phone (972) 219 -3548 fax (972) 219 -3506 8:00 A.M. - 12:00 Noon �' ° i�� �' 1 I U(
Lab ID 48146 EPA Lab Code TX01 — 143] 1 IlSarnple Bottle I.D. # t< a j
Address:
ate, Zip
Sample Its
;Lab Use Or:yj
Sample Co llection Information
o
U
Analytical results
Chlorin
`
Sample ID
Date
Time
a
x
(D
L
(Point of Collection)
Collected
Collected
z'
Q
Residual
0
a
"'E
(mg /L)
m
rn
r�
W
W
W
W
W
W
W
W
W
W
24
Water Sampling Information I
rn 2
I A
Analytical results
Sample Custo D ume Mon Name # of Bottles Relin Relinquished b ( J`-� , >/
1� � q Y # of bottles Date / 1 ou
tint Collected Signature relinquished Time p
Received By: # of Bottles Date / Time Relinquished By: # of bottles Date /
tint received Received Signature relinquished ] Time
Received for Lab: i # of Bottles Date / Time . Lab
ignature ` t.�Vl n received ' Received Comments
1 � + I (
Quality Control Data
Date / T i m e alysis: rolilert ical Met hod: Sample ❑ Form Incomplete ❑ Non - Coliform bacteria / silt present Approved By:
t _ / TM (SM9223) Flags: 11 Sample Outside Hold Time El Quantity too great to permit agitation
D
6 /y
P 01 SM 20th Edition ❑ Excessive Chlorine Present ❑Quantity insufficient for analysis
❑ Unsuitable Container ❑ Date: — C
aampie r ypetst: v - L..,rao; aampie matrix: vv - water; Preservation: I - samples iced down 1. Thermometer SIN: 51030428
q a White Ori inal : Returned to Customer as a report / Chain of Custody record; Yellow: Laboratory Co File ( 9� ) p y ry Copy ( Copy); Pink: Customer Copy at time of drop off ,.�, ,
Water of satisfactory bacteriological quality should be free from Coliform organisms.
Results above relate only to the samples on this report. � -. ff`
ECSL certifies that all results contained in this report were produced in accordance with the requirements of NELAC unless otherwise noted.
This report is intended for the sole use of the customer for whom the work was performed and must be reproduced, without modification, in its entirety.
Revision 1.3 3/3/2009 Page 1 of 1 Bac -T Form
aampie r ypetst: v - L..,rao; aampie matrix: vv - water; Preservation: I - samples iced down 1. Thermometer SIN: 51030428
q a White Ori inal : Returned to Customer as a report / Chain of Custody record; Yellow: Laboratory Co File ( 9� ) p y ry Copy ( Copy); Pink: Customer Copy at time of drop off ,.�, ,
Water of satisfactory bacteriological quality should be free from Coliform organisms.
Results above relate only to the samples on this report. � -. ff`
ECSL certifies that all results contained in this report were produced in accordance with the requirements of NELAC unless otherwise noted.
This report is intended for the sole use of the customer for whom the work was performed and must be reproduced, without modification, in its entirety.
Revision 1.3 3/3/2009 Page 1 of 1 Bac -T Form