Park West CC(12)-LR010403CITY OF L~WlSVILLE LABORATORY - WATER B,.,CTERIOLOGY
v4ame of Water System County
Poinl of ColleCted Collected By Date Ti~
(Mo/Day/Yr)
Repo.ing / ~
Address:
CITY TEXAS
TELEPHONE(~ ) ~'~'
Water System I~ntifi~tion Number
TYPE ~ Public
OF
SYSTEM: [] Other
[] Individual
SAMPLE [] Dislribution [] Special ~_ Construction
IS:
[] Repeal for sample #
[] Recheck for sample #
[] Other
WATER [] River [~ake [] Well
SOURCE:
Well deplh Chlorine Residual
~lC;.AJ,. METH~OD _& RESULTS:
· ,P.r. esen_~Absent: Total Colifor~"~ Present
( Coli~e ~"---'--~~ Present
M.P.N. Total Coliform
(Colilert) E. Colt.
Membrane Filter/Fecal Colifom3: 1st DiL /
/100ML
/100ML
mi 2nd____/__.ml
Avg.___/_ mi
Unsuitable For Analysis:
[] Form Incornplele (see encircled item)
[] Sample Ioo old, nol received within 30 hours of colleclion
[] Excessive chlodne present in sample
[] Unsuitable conlainer
[] Heavy, non coliform bacleria/sill present, possibly obscuring and compromising lest resulls
[] Quantity Ioo greal lo permit agilation
[] Quanlity insufficient for analysis (100 mi minmum)
[] Other ~. ~'~ ·
Analyzed by '
Water of satisfactory bac':erological quality should be free from Coliform Organisms.