Freeport NIP(2.7)-LR030522ass
CITY OF LEWISVILLE
, � aTl l na! Water S s em - � t� Aunty
(J cr <S yam s, ���;, Z. 0 7 0 0 0 ,00 o X II Point of Collodion o ted By Date Time
51 ►�±aYA,� L tJ (Mo/Day it • f3illing/ ?NAM / O
Reporting STREET rc
Address:
CITY IP /�� ! 'TEXAS 75 J�
C {� TELEPHONE ) `741- `/ �
Water System Identification Num
• / Public ❑Individual
SYSTEM: ❑ Ot her
SAMPLE ❑ Distribution ❑ Special
IS: I�Construction
O ❑ Repeat for sample k
❑ Recheck for sample 0
❑ Other
WATER n . M. M .
r
o ►�
0
,air ,S
SOURCE:
Well depth
Chlorine Residual
ANALYTI METHOD 8 RESULTS:
esenVAbsent: Total Coliloo�m `
Present
oil E: olt.
Present 5Absent
M.P.N. Total Coliform
1 M (Coltlert)
E. Coli.
1
Membrane Filter /Fecat Coliform: 1st Dil.
/-ml 2nd /ml
Avg. /__ml
3
Unsuitable For Analysis:
❑ Form Incomplete (see encircled item)
❑ Sample too old, not received within 30 hours of collection
❑ Excessive chlorine present in sample t
❑ Unsuitable container
❑ Heavy, non colibmn bacteria/sill present, possibly ybseuring and compromising test results
❑ Quantity too great to permit agitation
❑ Quantity insufficient for analysis (100 ml nlinmum)
❑ Other - I,
Analyzed by
Water of salstadory IrWwologiml quality should M ties from Coftrm Organisms.
M
In
It
O
7
BACTERIOLOGY
1
c
V�1
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0
m
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m
o
� 33
1
P �
n
8
e
r
m
m o
m
3
m
3
n
—1
r
r �
n
Unsuitable For Analysis:
❑ Form Incomplete (see encircled item)
❑ Sample too old, not received within 30 hours of collection
❑ Excessive chlorine present in sample t
❑ Unsuitable container
❑ Heavy, non colibmn bacteria/sill present, possibly ybseuring and compromising test results
❑ Quantity too great to permit agitation
❑ Quantity insufficient for analysis (100 ml nlinmum)
❑ Other - I,
Analyzed by
Water of salstadory IrWwologiml quality should M ties from Coftrm Organisms.
M
In
It
O
7
BACTERIOLOGY