PA9901-LR010601 (2) 1/ 9 q -0I
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CITY OF LEWISVILLE LABORATORY - WATER BACTERIOLOGY
C - ry .Ci CMOPPU -� a„..„, m r-
o CO g
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Name of Wafer System County - co v
-.4 c m
VI/.A W Pat;,r � -� 3 0
�� J �l If?: AM/PM m c
Point of Collection of acted By Date Time `
(Mo /Day /Yr) A l o
Billing/ NAME ! ^N �/ . p i r� X Gf`\l _a.•)� m c�'_, ..
Reporting
Address: STRE 1 f 5 AZFxt,o0zR � .O m
CITY_IA.,N ,At /-rut TEXAS r7 V 3X a
TELEPHONE( 5-7 ) �`l c )1.4 6 ) (ZPP Code)
Water System Identification Number .
TYPE o r r
OF Public r_] Individual C
m m m
SYSTEM:
❑ Other ,- , 0. Z •z
3 d o
` SAMPLE = 3 z
i d istribution ❑ Special Construction - " . m
IS: 0 _
Q
❑ Repeat for sample # ✓1 H m
[I] Recheck for sample # a) j
co
m f A.
❑ Other -- <
. . m
WATER ❑ R iL°f Lake ❑ Well
SOURCE: p
Well depth Chlorine Residual
/ 4l 0 3 AN YTICAL METHOD & RESULTS: 3 Present/Absent: Total Coliform Present Absent
(Colilert) } • dif Present .sent w
M.P.N. Total Coliform /100ML = =
Colilert /100ML
(Colilert) E. Coli. $
Membrane Filter /Fecal Coliform: 1st Dil. / ml 2nd / ml °
1 n
Avg. _ /ml
Unsuitable For Analysis: 1.? •
❑ Form Incomplete (see encircled item) kJ t
❑ Sample too old, not received within 30 hours of collection
❑ Excessive chlorine present in sample
❑ Unsuitable container
i
❑ Heavy, non coliform bacteria/silt present, possibly obscuring and compromising test results I
CI Quantity too great to permit agitation 3
❑ Quantity insufficient for analysis (100 ml rninmum)
❑ Other N /�/
•
Analyzed by /�
Water of satafactory bae erol ical q uality should be free from Coliform Organic bi,,,i,
i 1
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ra I •
.. LABORATORY - WATER BACTERIOLOGY
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Name of Water ystem County . - = m
i+ • a
l` f a c o
LiAe. Lvi 1_N. tt �`J t ICS AM/PM --__ c C
Point of Collection Collected By Date Time m " c
! MD
• Billing/ NAME "' ' t t (- t`• -J 4 ECGA.ofr AIG m
Reporting STREET /oZty S• ALE XLIN t`-)
Address: CD n
CITY 10 ✓A W TEXAS x 761; $
TELEPHONE( ) D. ci g - f y O (Zip Code)
Water System Identification Number .
p r- r
w
TYPE e
Public 0 Individual DJ w it
. °,
SYSTEM: Iii Other Z o
SAMPLE 3
jigtribution ❑Special Construction - : as n v
IS: N c
❑ Repeat for sample # ,`. J ,, o
❑ Recheck for sample # -- 5
m
"7 > N
❑ Other
WATER � �/ 1 -:1 '
❑ River a Lake ❑ Well I
SOURCE: --
Well depth Chlorine Residual CD .
0 o
ANALYTICAL METHOD & RESULTS: m 3
co
(P Total Coliform Present A s � ' 3
Present Absent cr ? - i
N
(Colilert) E:Coli. /100ML --" •
M.P.N. Total Coliform /100ML c_. ' a)
(Colilert) E. Coll. c -; : $
Membrane Filter /Fecal Coliform: 1st Dil. / ml 2nd / ml a
a
Avg. /ml
Unsuitable For Analysis: t -= ■
k.ri.
❑ Form Incomplete (see encircled item)
❑ Sample too old, not received within 30 hours of collection
❑ Excessive chlorine present in sample
❑ Unsuitable container
❑ Heavy, non coliform bacteria/silt present, possibly obscuring and compromising test results
❑ Quantity too great to permit agitation
❑ Quantity insufficient for analysis (100 ml minmum) A
❑ Other , tilJ t
Analyzed by
Water of satisfactory bac:erotogical quality should be free from Coliform Organisms.