Gateway BP(1.3)-LR 990405 (2)(~ITY OF LEWISVILLE LABORATORY- WATER BACTERIOL V
Name' o'f Water Sh/st, em.,/
Point of Collection Collected By Date Time
(Mo/Day/W)
Reporting STR[~
^ddre~: ~
CITY ,~, .~/'~ ~~..z~,/,~'/',~ TEXAS
Water Syslem Idenlifi~tion Number
Public
OF
SYSTEM: [] Other
[] Individual
SAMPLE [] Dislribution [] Special I-'~onstruction
[] Repeat for sample #
[] Recheck for sample #
[] Other ,.,,
WATER [] River E~La'~ke [] Well
SouRCE:
Well depth Chlorine Residual
ANALYTICAL METHOD & RE~SU, LTS:
.¢Pl~-~:u'~o~q:~; ~'~[~i ~u~l~'~'~'-'i: r:'~'resen!
~~ ~ ~~ Presen~ ,
M.P.N. Total Coliform
(ColileA) E. Ocli:
Memb~ Filte~Fecal Colifo~: 1st Dil. ~/_~
Avg.
Absent
/100ML
1100ML
mi 2nd
/ mi
mi
unsuitable Fo~Analysis:: ;'~ ,~":
[] Form Incomplete (see encircled item)
[] Sample loc old, nol received within 30 hours of collection
[] Excessive chlorine presenl in sample
[] Unsuitable container
[] Heavy. non coliform bacteria/silt present, possibly obscuring and compromising test result
[] Quantity too great to permit agitation
[] Quantity insufficient for analysis (100 mi minmum)
[] Other ~ ,. ~ , Analyzed by
ware*' o! satisfacto~' ba~rological quality shoul~ll~e ire~ from Coliform Organisms.