Freeport NIP(7.0)-LR030603Wi
C44
kr
Pro
('OE l f t +r
Name of Water System County
t -4 CtYle lore K 9 i
Point of Collection Collected By Date: Time
(Ma/Day/Yr)
Billing/ NAME C 1 A
Reportin
Address: STREET 2 1- 1 A 1 1-1 n P
CITY f a hi. 0 TEXAS 5115V
TELEPHONE(% 2 s 2 7.) 1 'zi r Code)
Water System Identification Num
TYPE Lya Public Individual
OF_ Other
SYSTEM:
SAMPLE Distribution Special Egtonstruction
IS:
epeat tor sample k f^ 3 r
Recheck for sample
Other AJ T Vf/
WATER River gLake 0 Well
SOURCE: Well depth Chlorine Residual
ANA I n� rTHOD RESULTS:
resent/Absent: Total Coliform Present
(Colilert) E:Colt. w... Present
M.P.N. Total Coliform 100ML
/100ML
(Colilert) E. Coli.
Membrane Filter /Fecal Colilorm: 1st Dil. ml 2nd !ym
>4:
Avg ml
m
w
0
Unsuitable For Analysis:
Form Incomplete (see encircled item)
Sample too old, riot received within 30 hours of collection
Exoesawe chlorine present in sample A
Unsuitable container Y I
HeaNy, non colibrm bacteria/silt present, possibly obsquring and compromising test results
Quantity too great to permit agitation
Quantity insufficient for analysis (100 ml minmu
Other
Analyzed by
w
Water of satisfactory Metrological qualify should be tree Cotbrm Organisms.