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Amberpoint BP-LR020513 (2)
~ 'lb Billing/ NAME Reporting Addi'el~: STREET W~er ~ ~t~l~ Nu~r ~PE OF ~ SAMPLE ~ o~ ~ ' ANAL~ICAL METHOD & RESULTS: ~~ Pres., TO~I ~ Water System Idectllfoaflon Number TYPE [~Pub~ l-m Individual .-~ OF SYSTEM: [] SAMPLE I-] Dm~ution [] Special !. ~Construction IS: [] Repeat for s~ple # : [] Recheck for sample # : " WATER D RiVe( SOURCE: Well depth __ r'"l Lake [] ANALYTICAL METHOD & RESULTS:~ ~senVAbseql: Total Colifo~ Present! "-"-~Colilert) E:Coli. Presem M.P.N. Total Coliform (Colilert) ' I~. Coil Membrane F It er/F~"~0 tform: Avg. /____ Unsuitable For Analysis: :.~:._ ~ ['"] Form IIll~:=O~l~e (~e ecC~'ChKI limn) ' : r-I saml~ Ioo old. nol received within 30 houm of e~inclion [] Ex~ cNodM ix~m, er~ in aa~pl~ I-I ur~u~u~ comair .:" [] Heavy, no~ c~ bacleda/~, pmsenl, po .~6becu~ng and com~oml~ng teat reaulta [] Quam~ ~mufr~wnt for mnmbmb (1 O0 nl rrdnmum) .,f/ CITY OF LEWISVlLIF Repo~llng ' C~Y Water Syslem Idenllllcatlon Number TYPE [~PubNe [] Individuel :' OF SYS~M: ~ ~h~ .:. SAMPLE ~ O~d~n ~ S~ial IS: ; ~ Ro~ ~r ~ ~Construction WATER SOURCE: ANALYTIC~AL METHOD & RESULTS: ,~?.esenVAbse~: Tqtel ColJform~ (Co~ilert) E:ColL M.P.N. Total Coliform (Colilert) E. CoIL Membrane Fil~er/Fecal Cogfoml: [-I River I--I Lake [] Well ~l Well depth ~,.Chlortne R~dual BACTERIOLOOy I-I Fom~ Irkeom~a (~ endrcl~ #.m) I-'] Sampb Ioo old. riel mceked Mlhln 30 houm of ~lbclion [] Heavy. no~ co~on~ I)ac~Mia/~l Pm~fll, pom~t, obacmlng and comptom~ng leal [] Quar, lllY too great Io i:)enra aOilMIo~ ¸*% , ! CO By D~e Bi#ag/ ~eponk~g Address: ~TflEET . TELEP~E~ Wa~ ~ ~nl~i~ Nu~ TYPE ~ubllc 0 I~vldu~ SYSTEM: [-I O~h~r /' SAMPLE I-I Oblribullon [] Special IS: ~] FI~ ~or sample # [] Recheck for sam~ # E] (~er. '" WATER SQURCE.~ gl River Well depth Chlorine F~Mdua] ANALYTICAL METHOD & RESULTS: (~'-Pr~ent/Absent: To~l Colif~') (Colilert) E:Coli. MEN. Total Coliform (C. ol, ilert) E. CoIL Membrane Filter/Fecal Colllon"n: Avg. UnSUitable For Analysis:. I'-J Fomt In¢eml~e (lie Ildrded Ilem) ' 'J~ ' [] Sampki too dd, not mootved within 30 houm of et~ec~m Do--.,....-- D Ot~r " "