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GTE (Clear C2)-LR121220 DRINKING WA R (P/A) COLIFORM SUBMISSION/REPORT FORM .4i*E€767,!;31.. Tarrant County Public Health Test results —_.._ requirements 7�")r�_.a. T:13 :� a . ,,k .'Sty I.�L :I. k' :>�,`•r s +'", .. }. ;,,_ .o.,, ,:;'�,r r i �,uyf_f it, * �':r',: North 101 South Main Street,Suite 1700 r om LACtB ,vR>,a .vA+.nt 5.,,. Public „tie tern ID: A� :Y 3.' Fort worth,TX 76104 unless stated ,_;be 7• (, ,.ude ell zeros �---� r Phone(817)321-4778 otherwise. Fax,.a,T��r�_ ( �,rl1 / _ ' /.. ....''':, TCEQ Lab ID:48010/USEPA7Lab ID:01471 NEL T104704339.124 Certificate 3124 , .,, .-n 1. ,,gavel County: .' , fii, f �_,_.. ' ,,,..�.. t�f� ts.��,�� f^ .., � �� Received T" � Date l Time 1- Name: 1 f A iJ ��7,© ttowtred• pp:- y`1 :s. a Address: , , M m,temperature Tasted //� Date/Time ', t r . at receipt? By: J�� L. Tested: EC City: [ /s.,., w State: I � Zip: � ��■■■■ / Reported M� Report DEC20'12 Aril ref: Phone#: dpi 477, 4, ' Fax#. / Report Approval Sampler Name: _ Sl9nature: IllirfrrrqpglrdIqPy l ��A�.� Sampler Contact#: • . e # ❑ owner ❑ Operator #EOther� t Tichn •,� r Date of a • Diane Nancy Approval 4/2 r:',' ,1.'1.,;,',. .n �' i;! �1 r.1a 1. . k, ti ' e 14 11T't s ' sr t J ;,, Director: ❑ Hardin ❑ Turns ., .... m ,...t,. ,r.�if�,a,A,..�Y.;9...,svme�'",ir ,t�*�C3�`��i�,av Ft _1k.L ,�-.a:t., ..� r� 4„t x3;r a�” „f.'v'� �t � ,yam Public I Private BottiedNended f n Groundwater(Well) Surface Water Lake.river) ' , i ik, ,m0 i " , ' ,.5:YA,x m' ` PIK i (Lake, 6� ,,tcJ t 4 'i t 1,..,A;a r �` t {t d "yz -rs4` §ks t i x f �,, '� t � �, T' ��^ 11�f „K .Other: t•Groundwater with Surface Water Influence :>h : t u�` a i' „ " r�. ` a ,g. ' x '1 ... 1 y_ �`5_fC,4 [ �S 1. ! f 44Af-..fi.^Sk St 'Er MkE x, . .::,a-n„nr d;M .,v., o .�:+:, .,,- ..t .:.-on a'YCS i: =y.C) .a..r,n .f, .c? i,P .�.N g.l, `9'J. c ,t, � Ex,, a�;E '�N.., �;... ,-, ,.y�._ �.'. ter �' -s+�.'�'t9f':.-.;. . , n , Y. ,.�r-. 1 & ,.Fl 4. �it , ,.,; .. y, ,fF+t I 10... f k i.i.,; 4.. d7�ae,c€s�e..p,.q .{ i':. .,s.,., s:. .,1 r.1,,.b A.i,;<rh,l if�,�s��`rw_.�� z: r W.4��ht t h~L . �. 'C f`� ,� ,r ,,. �:��` �5.� Free r, }.I .va 4,! l r. ,.� �t f rle� `� �, „. ,.en.,.:, ...�]=..n:.ax4s.,l..�.,. _,.r, .,a. e. rp/ ee �r z .i p f��£��t,£'�a'F t?rr�t � ti' ie c�s ,��.,.�*t;�}"n�`£t� >r� nelu.e a• o u a 1” + a Use Specific Addresskocation/Description Date Time r en ousP�niva m �t1:4 AMP ,:g,..-W4...n !„ ,. -;, ; ;<a'>• 1 v�' rig ' Y DO NOT USE SITE# >. Passe circle ! on nn Samples -.✓Total Rejection Tote/Collfo .�/ E coil -V r � h El Raw Wens Use Sotm'eW for WeHSa � 4 AM or PM r Related to the L� m Criteria* �� ! � � `� f-� f � rrfeed,•Ex.01234587A Or rinalSam•b IiSMITIMliS Eri--, 71 .,. >� Present ,�,;,,,i � 7��ti sn t rc,,,� �g © MIN= ��C-� DM ❑ ❑ ❑ 6 /Y)L ❑ ►:� k. 12[ 14 12 am 111111 pm ❑ ❑ ❑ ❑ ❑ f ❑ 11rg ❑ l 1 .111 P p ❑ ❑ ❑ ❑ ; ❑ ❑ ❑ ❑ LIIUU ❑ ❑ ❑ ❑ ❑: M� ❑ ❑ ❑ ❑ i■■ ' 11 in ., ❑ ❑ ❑ ❑; ❑ ❑ 111 ■ MIMI P ❑ ❑ ❑ ❑ ❑: ❑ ❑ ❑ ❑ 1 fd(r 4 iGS•dd,v I AEI m ❑ ❑ ❑ ❑ ❑ : ❑ ❑ ❑ ❑ -i- 4d ,,. toll. ■III■ ❑ ❑ ❑ ❑ ❑; ❑ ❑ ❑ ❑ IIIIIIIIIIIIffall EMI ; 0000 0, ❑ ❑ ❑ ❑ ■.. p ❑ ❑ ❑ 0 ❑ ❑ ❑ ❑ Coiiform P/A fat r W 1) Sample Too old. Not received within 24 hours of collection 3) Excessive Chlorine Residual(>10 rri L) 5) Form incomplete/Date Discrepancy(Errors Circled) Form:3/2012 e t 2) Quantity insufficient for analysis 120mL required) 4) Heavy SlIvTurbidil Present 8) Other: 23 a,�s t� re•., �,-��z ._ ) till' �( reQ d) Y } DRINKING WA R (P/A) COLIFORM SUBMISSION/REPORT FORM .ice.•.. Tarrant County Public Health Test�u� 7 g Laboratory Dements meet ell North Texas Regional Laborato r�''r, ^�; r , i�7,1 _ " -a `V -acs T1 1:, t 5 �,t...1 c o f _ '"id,<�o,. t�,r�l � �:, � f- ��^� s„�:E,�w,�.�,. �:�!.� �,,,hL�, aW-�,.,�.J..�,. }�., . . _.,1�. f..:�r?d,,.�? ...,f r4 r.� tr.� 1101 South Main Street,Suite 1700 of NELAC Public .te tern ID: s 1,: v,= Fort worth,TX 76104 unless stated • be 7 .ude all zeros �� ---� ,. :.•' Phone(817)321.4778 otherwise. ublic,'+` �`�/_ — *,'. Fax(817)321-5378 NELAP Certificate#:_ ,: •s r;,r u r �� • - �' TCEQ Lsb ID:460101 USEPA Lab ID:01471 T104704339.12-4 f Sample Iced? min Received l Date l Tite C Name: t J �, / taavad. 1 DEC A'12 ' 1 le a rro,temperature Tested p Data 1 Time S” Address: , `, strawipt? By: /If�L Tested: CC City: Air.Iii �3 a Reported Dab!Tim. __ .x c State: ' . Zip: i•1ipas��m■■■■ C By: M� ate/Tad: E f d; t f " r�°:�'f`' <<�a ' Phone# / Fax#• Report Approves Sampler Name: I ' Signature: A Illinfrpparria, pi J •yi�('� ��/ l �y Approvin•ii f ' Data Of Sampler Contact#: a i / .� ❑ owner Q operator /they � Technic. .: .. . Diane , , x . Y;•` gl E 5„ ! a a z 01 z:4?%- , ,,: �„,": 0, ' ; Drecor Hardin ❑ Turnage mo Public I Private BotedNended E1 y Approval. Groundwater(Well) Surface Water(Lake,river) : I fr,` ,r��' i ?"4 ��` �,�AZit�'' � =1��la II ,;r t 1. Hn'`Ir' Vi T v teat d1.-- Y,� p4 41 Other: Groundwater with Surface Water influence 1')_ arti, m " ,1 t 1 n, ,, i- 1�al -.-:..,. � i F:-� '.' „"� .Y-u;B . . .m'. .. �,;W . : .. sr .�a'<•'�'�i.. }tb�. r.. �z t; � .uk Vail, t f,��v lf� -5 i s 5,. -,' @: � ,1 x �I,. r_t y rP, .Y,,9� 4 �. 1 c, �af� `'; t z • .:s z ,� 4s ay _ "�.,��; ,-:�. ; �i� ,_r E,;,k,,.� .t� ��gg�y�y �t „t��;4' � ::� .. a ,7 .. „ � r� ,�,' aT� Free +� ,I� .w ,.. .� a.,�.".,.�su� � �. ,,, k�, � A ��,. .:.'�u l�'u�S '..�w,� ...,z��. zbx...,,�a rr�i, >:M1,. �-, Y . �. � �' bra � �. Incite::Lab o ? , � n 7s;SFZ4r � �" r1s USBStDBCI(IC.Odd!'B&S✓LOC3ti0i1�DasC1llUt101i Date Time +-' I PreviouePoeitiva m '��"` ''� gf,! ==':' .�_ ,;,,,,i ,... .iw_ ...,...a'5 t i ,lw ''' '�51P7:0• DO NOT USE SITE 0' ® 8 i on an sampias Total Conform E.coil �k z j,4e'is 2V T Please , Total Rejection c � Raw Wells Use Soone lD for Well Sampled;Ex01234567A 0 AMO,Pnt ', - A Sam•b Criterla# Present Abs- R, M ,'V; .wj,,h+3Prl�rt7( ?x,14 riffirrilinill Fkl Mgr W li ❑ G ❑ ❑ ❑a 6 /AL ❑ ► Jii 12014212 1111111 p 0000El; ❑ lag ❑ ❑ IIIIIIIIIIIIIIIIIII VIM am pro 0 0 0 0 0: 0 0 0 0 \ ► ■ pm 0 ❑ ❑ ❑ ET 1111110 ❑ ❑ ❑ f f ■`� am pm ❑ ❑ ❑ ❑ ❑; ❑ ❑ ❑ ❑ em 116 tf.ALr CS:44i1 III pm ❑ ❑ ❑ 0 ❑; -_ ❑ ❑ ❑ ❑ ._.B11..■ a ❑ ❑ ❑ ❑ ❑! I-_ ❑ ❑ ❑ ❑ MINI 1 conform P/A rp',1 r�, ''`'1) Sample Too oid. Not received within 24 hours of collection 3) Excessive Chlorine Residual(>10 mg/L) 5) Form incomplete/Date Discrepancy(Errors Circled) Form:3/2012 1}e i ` t` st y ',� „, n. z, 4.4 „i,',,,,,N , 2) Quantity insufficient for analysis(120mL required) 4) Heavy Sllt/furbidity Present 8) Other.