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Coppell Ind 2-LR130131 (2) Water Bacteriology Report/ Chain of Custody Record City of Lewisville Environmental Control Services Laboratory Samples Accepted Customer Comments: Report# LEWIS VI ,',,F 897 Treatment Plant Rd.,Lewisville,TX 75057 Monday -Thursday Deep Rom.Proad Mrtds ertea fore. Phone(972)219-3548 Fax(972)219-3506 8:00 A.M. - 12:00 Noon '1.016.- /(0 Lab ID 48146 EPA Lab Code TX01143 I II Sam p le Bottle I.D. # /� Ja/( Customer Name. _.-4(HA e 67,,,g"I", 'roject Name: Project# Customer Address: a-/ab /A l�J/lt'i‘,/ti -roject Address: Q6? (...e r445,44,..)NrG 8a7�-4J Contact:a/y_31S _/�4/ City,State,Zip �t�i yg q /1„.X 75 9 4/ ity,State,ZIP :: c:i1F 7-i-t 76 o/4 L'f�4�d Phone# Phone# G'/7,_- $31, - p.__/,I$ Fax# ater System ID# 05 1 b 0 ,/110 ISample Collection Information Water Sampling Information I Analytical results © Type of Sample Water d Total ti Chlorine Results rn E.Colt N n Collected source . 4 Coliform m"Co' p m a c m Sample to rD Sample ID Date Time a a X o Q LL (Point of Collection) Collected Collected E . .s o E o a m =�- r; Residual u o Z 41 7 = N ,_ v v a E ar °—' d 754 .49 44101, (mg/L) �o .�. m a� - ° ._ 2, > m to r E a E e.. j a s 'i d m 3 47. d 2a m E V o 2 ti 2 t° = N 0 t0 m ."0-i K u 8 o R 0 C. O 0 m � to 8 c = - 2a) _ 00 0) va 'CO,,1-- .,.4 4,• iL re C co o m Cl) 12 ui LL z LL z D Sod jD.'85 Ail O/ 3//3 S G W t p,5 .4/- x Ahk . A4,114 /0,-3/ An Oi/? /3 ..t,tr G W 4 0 - . _$ p,s ✓ r j t- x �� )%,Sli r P A O .D: O N 3 Iv G W x 1/ L/ /7 _{.. X G W r . -, X _ _ G W R X G W X i G W X I I 1 G W P:Falzi X G W x G W s ,..1 X Samp ustody Documentation Samplers Na e: #of Bottles n Relinquished by: #R of Bottles t Date I 1-3 ,. 3, Print ilb 40A Collected .3 Signature elinquished Time II, 4G �r _ Received By: #of Bottles Date/Time Reli quished By: #of Bottles Date/ 1' Print Received Received Signature Relinquished Time Received for Lab: ) t ( #of Bottles 3 Date/Time V Lab Signature IVAV{ t Received Received 1-I'- Comments (Ijl/t 1 I' q C Quality Control Data Date I Time Analysis: Analytical Method: Sample ❑ Form Incomplete El Non-Coliform bacteria/silt present Approved By: I �i ' )� Nl biColilert TM(SM9223) Flags: ❑ Sample Outside Hold Time ❑Quantity too great to permit agitation 1/ D SM 20th Edition ❑ Excessive Chlorine Present El Quantity insufficient for analysis 1Vy ❑ Unsuitable Container ❑ Date: a, -,-I Sample Type(s): G-Grab; Sample Matrix: W-Water; Preservation: I-Samples Iced Down; Lab Chlorine Residual: ND-Not Detected,D-Detected 1.Thermometer S/N:51030428 White(Original): Returned to Customer as a report/Chain of Custody record; Yellow: Customer Copy at time of drop off "°` Water of satisfactory bacteriological quality should be free from Coliform organisms. ,ta?'"` Results above relate only to the samples on this report. ECSL certifies that all results contained in this report were produced in accordance with the requirements of NELAP unless otherwise noted. t, 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 1.5 7/31/2012 Effective 7/31/2012 Page 1 of 1 Bac-T Form