Mansions Phase 1-LR 980219 (4) TA,"'~NT COUNTY I~LIC HEALTH LABORAT.t~-''..
:. "- 1800 Universi~'r., Ft. Worth, TX 76107
; WATER BACTERIOLOGY Leblllo. 48010 (817)g71-7246
T
': Date and Time R~..d,", ~ -- ~ ~ Date
Do Not Mark Above This Line -----Please Print Below with BALLPOINT PEN OR ~PEWRITER:
NAME 0F WATEB ~TEM
POINT OF COLLE~IONIS~LE DESCRIPTION Water S~tem I.D. No.
R~LT~ ~TR~T ADDRE~ ~.0. ~ox)
?: CI~ ' ' (Zip Code)
r PHONE ~ COUN~ ,
al ll l l l?l =101ol I/1 1
~F~Colleen Month' Day Year ~ TIME ~M[~ Colle~ed By
~ ~PE OF SYSTEM SAMPLE IS ' WATER SOURCE
~ ~lic ~Dai~ ~ Distri~t~ ~Raw ~ ~River ~ke
~' ~l~ividual ~tt~ ' ~onstru~n ~R~t ~ ~Well
~ ~1 ~V~ded ' ~61yc~llSk~tlChill Water Well Depth
~- ~0ther ~' Chlorine ~sidual
-~ A~itionallnfo~ation:
LABORATORY REPORT {Do no write below) TECH
MMO-MUG Membrane Filtration (MF) MMO-MUG
PresencelA~ence Most Probable Number (MPN) '
Coliform Organism Coliform Organisms Coliform Organisms
--~Not Found ~ ~ Not Found ~ Not F~d
~ Found J-' ~ Found .~ '.~ Found
~ Total Colifo~ group ~~ Colfformll00 mi Total
~" ~ E~ef~ c~i E. cd¢lO0 mi Coliform: MPN/10Oml
· ~ ~ R~eat sables r~uired Fecal Colfform~ll00 mi ~cd~' MPNI100ml
;" ~ Unsuitable -- ~ below ~ Unsuitable -. See be~w ~ Unsuitable -- S~ bebw
~ UNSUITABLE FOR ANALYSIS-PLEASE RESUBMIT
~- ~ S~le too old. Saqle not mcdved ~ O~ntity insufficient for an~si~-
~ ~thin 30 hours of collation (100 ~. r~uired)
.- ~ Date discr~cy or from inco~lete ~ Heavy [siltlbacterial gro~h) present,
: {~e encircled it~) possibly co~romising test results
~ Leak~ ~ tr~sit ~ Sample receiv~ on Friday
. ~ Ouantity too great toper~t aghation ~ Other
~ Excessive c~rine residual: ~IL