Freeport NIP(7.5)-LR010614 (3) CITY OF LEWISVILLE LABORATORY - WATER BACTERIOLOGY
Point of ColleCtion Collectdd By Date Time ~.~
(Mo/Day/Yr)
Address: STREET _
TELEPHONE( oc':/ ~ ) ('/Y ~ '" ~ q{ ~ Code)
TYPE [~Public [] I.dividual
OF '
SAMPLE [] Dislribullon [] Special [~ Construction ~
IS: [] Repeat for sample~ ' ' '
· [] Rechecls for sample #
WATER [] River ~'l_ake [] Well 5,."' F,~cd__
SOURCE:
Well d~plh ChlOrine Residual
a_. wnc u['r.or & RESULTS::
(Colilert) t::L, .~ _ Present
M.P.N. Total Coliform __./1OOML
/tOOML
(Colilert) E. Coil.
[ Membrane Filler/Fecal Coliform: 1st Dil. / mi 2nd / mi
Avg. / mi
U~suitable For Analysis:
[] Form Incomplele (see endrcled item) '
[] S~apb too o~d. no~ r~iv~l w~hin 30 houm of million
,- [] Heavy, ~ coliform bacteria/silt pmsant, possibly obscuring and compromising leSt remits
[] Quanfl~ too ~t to permit a~it~ion
[] Quantilyibsuffidenl fmanalys~s(lO0 rrd minr~um) ,~. (/~,
[] Other
Analyzed by
Watm o~ sati~fa~:~y ba~0~ogieal qualily should be free Irom Coliform
CITY OF LEWISVILLE LABORAT RY - WATER BACTERIOLOGY CITY OF LEWISVILLE LABORAT ¥ - WATER BACTERIOLOGY
Name 0t Walef Syslemf/' ~ Name of Waler System - ~ ' J
Paint e~ aoae~ke Col~ .~ b-~ ~ ' j~ Point et Co.~iek fL,'i/.4,~ ~ s¥ Dst, dine ._~
(Mo/Day/Yr) ~ ' ' (Mo/Day/Yr)
CITY., C~ ~ -~ ~ ~/~ TEXAS -~
TELEPHONE(C~?) ~.?/ ..~ ~,Code) TELEPHONE( (~ ? ) ~(~ - ~.~(Z~Co~)
· Water System Identification Number ., Water System Identification Number
· -lhq~E
TYPE ~.Public E] Individual ,~'): ~)l':t(, j'~ --~-- ~_ ~'Public I--I Individual
OF ~, o ~ OF
SYSTEM: [] Other. '~-
IS:
[] Repeat for sample # ': ~ [] Repeat for sample #
[] Recheck for sample It '~ ~' [] Recheck for sample #
, p Other, ~' [] Other <ir
' ' ~ ~'~,r $ :'~' WATER
W~TER [] River [~ Lake [] Well [] River [~ Lake [] Well
SOURCE: SOURCE:
Well depth' Chlorine Rpsidual , Well depth Chlorine Residual
~ ;g ANALYTICAL METHOD &~ESULTS:
ANALYTIC:Al MFTHOD & RESULTS:
Pr~P'~-es~nt/Absent: Total COl'~ Present Absent ! ~t/Ajsent: Total Coliform ~ Present
(Colilert)
' E.'Coll. Present ' Absent ~'O~ilert) E:Coli. Present
M.P.N. Total Coliform __/100ML M.P.N. Total Coliform '/100ML Absent
(Colilert) E. Colt. __/~00ML (Colilert) E. Colt. /100ML
MembraneFi#er/Fecal.Collform: lstDil. / . 4a~ 2nd___ / .mi MembraneFilter/FecalColilon~: lstDil. / mi 2nd .:___/ mi
Avg / mi Avg. /_____mi
Unsuitable For Analysis: '~
,~ .~;~, Unsuitable For Analysis:
[] Form Incoml:~le (see ancircted ilern) t-'- ~-I [::] Form Incomaiste (see encircled item)
'1--1 Sample Ioo old, nol received within 30 hours of C°ll~ction [] Sample Ioo old, no~ received within 30 hours of collection
· [] Excessive chlodne presanl in sample [] EX~e chlmtne preserfl in eample
[] Heavy, non coliform becleria/sill pmssnl, possibly obscuring and compromising lea resulls [] Heavy, non coliform bacleHa/silt pmsanl, possibly o .becuring and compromising lesl results
[] Quanllty too grea, ,o -- ,gilation .~ (//~, r'-] Quanflly ioo gmat Io perml agltalion
[] Quanlily insufficient for analysis (100 mi mlnmum) [] Quanlliy insufficient for analysis (100 mi minmum)
[] Other .... [] Other
Analyzed by Analyzed by