Wynnpage Plaza-LR020716CITY OF LEWISVILLE LABORATORY - WATER BACTERIOLOGY
Name of Water Sysl®m County
'7'-/~--~//
(Mo/Day/Yr)
Bilfin~ NAME P ~.~
A~ress:
TELEPHONE(~) ~Z ~ 7~~)
Water System I~nli~tion Number
P6int of C611ectibn Collected By
TYPE ~c [] Individual
OF
SYSTEM: [] Other
SAMPLE [] D~ribulion [] Special [~c'~"~ruction
IS: [] Repeat for sample #
[] Recheck for sample #
[] Other
WATER [] River [~L"~e [] Well
SOURCE:
Well depth Chlorine R. esidual
ANALYTICAL METHOD & RESULTS:
Present - -'
__/100ML
MP.N Total Coliform /10OML
(Colilert) E. Coli.
Membrane Filter/Fecal Coliform: 1st Dil. /___mi 2nd ____/.__.mi
Avg. / .... mi
Unsuitable For ~:
[] Formate {see mlcimled item}
[] Sample too old, onl received within 30 houm of coll~lion
[] Excessive chlodne presenl in sample
[] Unsuitable container
[] Heavy, non colilorm bacteria/siit pmsenl, possibly obscuring and compromising lea msuits
[] Quantity too great to permit agitation ~ -
[] Quantity klsufficient for analysis (100 mi minmum)
[] Other ~/ ~ '
Analyzed by
Water of s~tn~actoty ba~,,~ological q~al~ should be