Coppell BC3-LR000727WATER BA~.. ~JOLOGY
~,l{lame of Water System County
Point of ColJ'eclJc~h Collected By Date Time
. IMo/Da~/~r)
Billing/ NAME-'-~-'~_-'~ -- ~)[~ C... /~S ~
RepoSing -~ ~
Ad.ess: STREET~ ,~ ~~(~, ~
TEX*S
TELEPHONE(~}~ I [~- ~ ~(~C~)
Water System Identification Number
TYPE [~Public
OF
SYSTEM: [] Other
[] Individual
SAMPLE [] Distribution [] Special [~Construction
IS;
[] Repeal for sample #
[] Recheck for sample #
[] Other
WATER [] River ~Lake [] Well
'SOURCE:
Well deplh Chlorine Residual
ANALYTICAL METHOD & RESULTS:
~~otal Coliform Present
~~ E:Coti. Present
VI.P.N. Total Coliform
(Colilert) E. Coll.
Membrane Filter/Fecal Coliform: 1st Dil.
Absent
-/IOOML
/ 100ML
__ .r~ and / mi
Avg / mi
Unsuitable For Analysis: . ~
[] Form Incomplele (see encircled item)
[] Sample ~oo old, nol received within 30 hours of collection
I-'J Excessive chlorine pre~enl in sample
[] Unsuilable COntainer
[] Heavy, non coliiorm bacteria/silt present, possibNobseuring and compromising lest resulls
[] Quantity 1oo greal Io permit agitation
[] Other .. , \
. '/Analyzed by _ _ 4Q:7~
Water of satisfactory bac:.-rologic, al qual~ should be fre~ from Coliform Organmms
CITy. ~)F LE~..$VILLE LABORATORY -'WATER BAc'fERIOLOGY
Billing/
Reporting
Address:
Collecled' By Dal:ll
~. . (Mo/Da~/Yr)
Water SYslem Idenlilicalion Number
TYPE
[~ublic [] Individual
OF
SYSTEM: [] Other
SAMPLE
[] Distribution [] Special ~~on
IS: ~ ..
~ [] Repeal for Sample #
[] Recheck for Sample #
"[] Other "i
WATER [] River ~ Well
SOUl, CE: Well depth .Chlorine Residual
oTHOD & RESULTS:
I Coliform Present
Ii. Present
M.P.N. Total Coliform
(Cplilert) E. Coli.
Membrane Filter/Fecal Coliform: 1st Dil. /
/IOOML
/IOOML
r~! 2ncl ____/.__mi
Avg. /.____mi
Unsuitable For Analysis: ....
[] Form Incomplele (see encircled item)
[] Sample too old, not received within 30 hours ol collection
[] Excessive chlmirm present in sample
[] Unsuitable container
[] Heavy, non colilorm bac~eria/siit present, possibly obsquring and compromising test results
[] Quantity too great Io permit agitation
[] Quantily insufficient for armlysis (loo mi minmum)
[] Other