Park West CC(3)-LR000112CITY OF LE~'--'lILLE LABORATORY - WATER BA(' RI•LOGY
Narr~ of Water System
Billing/
Reporting
Address:
County
Point ot Collection Goltecled By Date Time
yo/Day/Yr)
CITY 5 °~7~[~e TEXAST~ o~
TELEPHONE~.~) ~/' Z~ (Zip C~)
Water System Identification Number
TYPE
OF
SYSTEM: [] Other
__ Individual
SAMPLE
IS:
[] Dislribuhon [] Special
[] Repeat lor sample #
[] Recheck for sample #
[] Other.
~ction
WATER [] River [] Lake
SOURCE:
Well depth
[]
Chlorine .Residual
ANALYTICAL METHOD & RESULTS:
(~sent/Absent: Total C0iif~rm.m.m.~ Present
(Co~ilert) E!Coli. Present
M.P.N Total Coliform
(Colilert) E. Coll.
Membrane Filter/Fecal Coliform: ls! Dit. /
/IOOML
/IOOML
mi 2nd____/ ___mi
Avg._.___/ mi
UnsuitabLe For Analysis:
[] Form Incomplete (see encircled item)
[] Sample too old. nol received within 30 hours of collection
[] Excessive chlodne present in sarnple RECEIVED
[] Unsuitable container
[] Heavy, non coliform bacleria/silt preser~t, possibly obscuring and compromi~t~sJire.~ult~)nnt~
[] Quantity too great Io permit agitation -
[] Quantity insufficient for analysis (1 O0 mi minmum)
•Other Analyzedby~,'~ , 'TR! DAL, Ltd
Water of sabsfactory bacterolog~cal qualRy s(wl~uld be free from Coliform Organisms.
CITY OF LE~-- VILLE LABORATORY - WATER
Name of Water S~stem County
Point of Collection Collected By Date
(Mo/Day/Yr)
Billin~ NAME ?/~('
Repoding
Address: STREET
TELEPHONE, ) ~/~1' ~ (ZipC~)
Water System Identification Number
TYPE
~"~c ~.~ Individual
OF
SYSTEM: [] Other
SAMPLE [] Distributio. [] Special C[~'~onstruction
IS:
[] Repeat lor sample #
[] Recheck for sample #
[] Other
WATER [] River [] Lake [] Well
SOURCE:
Well depth Chlorine Residual
ANALYTICAL METHOD & RESULTS:
('15"'~sent/Absent: Total ColiforTn.~ Present
(Colilert) E:Coli, Present
M.P.N. Total Coliform
(Colilert) E, Coll,
Membrane Filter/Fecal Coliform 1st Dil,_ __/ ____
/IOOML
· / 100ML
'mi 2nd /
mi
Avg. _ _/ ___mi
Unsuitable For Analysis: _
[] Form Incomplete (see encircled item)
[] Sample ,ooold, nol received within 3O hours of collectio, RECEIVED
[] Excessive chlorine present in sample
[] Unsuitable container
[] Heavy, non coliform bacteria/silt present, possibly obscuring and comfier
[] Quantity too"great to permit agilation
[] Quanlib/insufficient for analysis (1 O0 mi minmum)
•Other fBI DAL Ltd
Water of satisfactory bact.~ro~ogical quality s¢ld be free from Coliform Organisms.
CITY OF LE~~ VILLE LABORATORY - WATER BAC RIOLOGY
Name of Water System
Billing/
Reporting
Address:
County
Point of Collection Collected By Date Time
(Mo/Day/Yr)
NAME ~- '''~¢~ '~'1(' '
STREET ~-~/~
CITY ~ d'**;
TELEPHONE~__~ ~t~~ f' ?' ~' I; ~., (Zip Code)
Water System Identification Number
OF
SYSTEM: [] Other
individual
SAMPLE [] Distribution [] Special tion
IS: [] Repeat tot sample #
[] Recheck for sample #
[] 01her.
WATER [] River [] Lake [] Well'
SOURCE:
Well depth Chlorine Residual
ANALYTICAL METHOD & RESULTS:
sent/Absent: Total ColifoFm_.m_.~ Present
oilier[) I-:COll. Present
M.P.N. Total Coliform
(Colilert) E. Coll.
Membrane Filter/Fecal Cotilorm: 1st Dil. /
/100ML
/100ML
mi 2nd
Avg /__ . _mi
0
Unsuitable For Analysis: :--
[] Form Incomplete (see encircled item)
[] Sample too old, nol received within 30 hours of collection
[] Excessive chlorine present in sample RECEIVED
[] Unsuitable container - ~
[] Heavy, non coliform bacleria/silt present, possibly obSCuring and comp~q~e~J:re~t~0
[] Quantity too great to permit agitation
[] Quantity insufficient for analysis (1 O0 mi minmum)...
•Other Ti;II
.,'-, --L'' DAL, Ltd
Water of satisfactory bac*.~rolog~c~l quality sCuld be free from Cotiform Organis .