Asbury Manor-LR 971215 (4)CITY OF LEWIb. ~LLE LABORATOR~Y - WATER
Na. of Water System County
Point of Collection Collected By Ti~ ~PM
(Mo/Day/Yr)
Billin~ NAME ~ ~ ~ ~/~ ~ ~ ~
~ddms~: Sl~fifil
TELEPHONE( ~/? ) 2b 7- ~ 2 ~P C~)
Water S~st~m Idan~ifi~tion ~umb~r
OF ~¢~ C
SYSTEM: ~ ~her ~ ~
SAMPLE ~ Dislribulion ~ Special ~onstruction
IS:
~ ~echeck ~or sampl~ ~
~ ~her
WATER ~ River ~ Lake ~ Well
SOURCE: Well depth Chlorine Residual
Present'Absent: Total Cohform Presem
Fecal Coliform Present
M.PN. Total Cohform ~100ML
Fecal Colifo~ /100ML
Membrane Filter/Fecal Colifo~: 1st Dil.__,'__ml 2nd / ~ml
Avg __..' mi
Unsuitable For Analysis:
[] Form Incomplete (see encircled ilem)
[] Sample too old, not received within 30 hours of collection
[] Excessive chlorine present in sample
[] Unsuilable conlainer
[] Heavy, non coliform bacleda/silt present, possibly obscuring an,d,~,ompromising test results
[] Quantity too grsal to permit agitallen l
[][] OtherQUantity insufficient for analysis (100 mi minmum)
Analyzed by
Water of sahsfactory bac:,erological qual~:y should be free from Coldorm Organisms.