Villas of SW-LR140219 Water Bacteriology Report/ Chain of Custody Record
City of Lewisville Environmental Control Services Laboratory Samples Accepted Customer Comments: Report#
.. I , ; 897 Treatment Plant Rd.,Lewisville,TX 75057 Monday-Thursday ,1�o 0�
wxst sruwrt, Phone(972)219-3548 Fax(972)219-3506 8:00 A.M. - 12:00 Noon I r� 02,1 'S
Lab ID 48146 EPA Lab Code TX01143 I Sample Bottle I.D. # B / 3
Customer Name: { �� Project Name: V I I I 6.3 c�4 ,h ��y71lrA Project#
Customer Address: ,3 y l(.) N/) j(til0 fCl( "roject Address: ?� -5' f A G 4,47,:crri L Contact:
City,State,Zip J-4,14'1, 76 e L.to
ity,State,Zip /o)i/)f I x 7 Phone#
Phone# 9 YO J 1.jc s-7,3-2
Fax# ater System ID#(' t 7
Sample Collection Information Water Sampling Information . Analytical results
d
Type of Sample water " Total
Chlorine Results 'Q E.Coli y
Collected Source m Coliform
_ a ¢ c +T
Q N
Sample ID Date Time • W x <o c c o
(Point of Collection) Collected Collected S .2 i € �, a
F m Residual u o E
Z (m9/L) p R iyo Q o ; m m
E E Cu m 3 :2 w .6 G m E U ° C L° W W
m H 0. O W c N m U 2 . W•in Cn LL CC I' cn V cc W ll Z ILL Z
I W I I I I X I I I
� ♦ l ♦ G W X
. 1 •I 1'' 'I G W - _ X
G W x
A G W X
.w.: • G W X
!' '�L Sample Custody Documentation
amplers Name;/� r r}—_ ic, N4 ( 1,W Coltlected Bottles l Signature
by n�� �� #of Bottles Date/, ��
Print Tr) 1 V` 1V ` Relinquished Time z"'�
Received By: #of Bottles Date/Time Relinquished By: #of Bottles Date/
Print Received Received Signature Relinquished Time I I,ti vtW♦
Received for Lab: #of Bottles Date/Time 7,—�...—t 1 Lab
Signature Received ` Received , Comments
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Quality Control Data
Date/Time Analysis: A alytical Method: Sample Approved By:
❑ Form Incomplete ❑Non-Coliform bacteria/silt present 1
r 1 1 l Colilert TM(SM9223) Flags: ❑ Sample Outside Hold Time ❑Quantity too great to permit agitation 1�1 ,_
�I�f 7 Y SM 20th Edition ❑ Excessive Chlorine Present ❑Quantity insufficient for analysis V� FR-A"
❑ Unsuitable Container ❑ Date: k 1 °\-1
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
r� Water of satisfactory bacteriological quality should be free from Coliform organisms.
Results above relate only to the samples on this report. I;
ECSL certifies that all results contained in this report were produced in accordance with the requirements of NELAP 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 1.5 7/31/2012
Effective 7/31/2012 Page 1 of 1 Bac-T Form