Magnolia Park-LR 980703 (2)CITY OF LEW! LLE LABORATORY - wATER BAC OL Y
Name of Water System
Point of Collection Collected By
Billing/
Reporting
Address:
Water System Identification Number
County
D~ Time
: (Mo/Da ~e~Y~r)
SYSTBiM: [] Other
SAMPLE [] Distribution [] Special
IS:
[] Repeat for sample #
[] Recheck for sample #
[] Other.
[~onstruction
WATER [] River ~'C~° [] Well
SOURCE:
Well deplh Chlorine Residual
ANALYTICAL METHOD & RESULTS:
Present/Absent: Total Coliform
(Colilert) E:Coli.
M:p.N. Total Coliform
(Colilert) E. Coll.
Membrane Filter/Fecal Coliform: 1st Dil.
Avg
Present
Present
/i00ML
/_ . mi 2nd
/ mt ''~
/ mi
Unsuitable 'F~)r AnalFsis: ..... .,
[] Form Incomplele (see encircled item)
[] Sample Ioo old, nol received within 30 hours of collection
[] Excessive chlorine presenl in sample
[] Unsuitable container -
[] Heavy. non coliform bacteria/sill present, possibly Obscuring and compromising le
[] Quantity too greal to permit agitation
[] Other
Analyzed by
wate~ of satisfactory be~erological quality should be freeY°m Coliform Organisme.
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