Town Center West-LR010627CITY OF LEWISVILLE LABORATORY - WATER BACTERIOLOGY
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Name of Water System C o z
W. Ta+✓"/ R .! u d�r�, X4 AANPM •
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Point of Collod C
ion ollected BY Date Time o
c Billings NAME U
Reporting STREET �
Address:
CIT Y zewi , S✓r ��� TEXAS c
TELEPHONE( C� .
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Water System Identification Number ajP
TYPE ,,_,// m
t}�Public ❑Individual n Q z
OF
❑ Other o
'.j SYSTEM: ^', � °' z
h SAMPLE ❑ Distribution ❑ Special Construction c e n _
r IS: w m Ifs CYY�
❑ Repeat for sample IF
C) Recheck for sample #
❑ Other - —' YJ - o d •v 1
WATER ❑ River Fake ❑ well
SOURCE: Well depth Chlorine Residual
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AN ETHOD &RESULTS: -' g
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re'entjA olal Coliform Present Present Absent '� w
t an E:C011. /100ML
M.P.N. Total Coliform /100ML $
} (Colilert) E. Coli.
(t! o
ti Membrane Filter /Fecal Coliform: 1st DiI._1 2nd __ /_ml �' g
� Avg_I__ml
47
Unsuitable For Analysis:
❑ Form Incomplete (see encircled item)
❑ Sample too old, not received Within 30 hours of collection
❑ Excessive chlorine present in sample
❑ Unsuitable cordanter
El Heavy, non colifomn bacteriatsih present, possibly obscuring and compromising test results
s ) ) i+ F ' ❑ I]uaMity too great 10 permit agitation
�I ❑ ouaMtty insufficient for analysis (100 ml minmum)
R, ❑ Other \
r Analyzed by
1 Water of ulelaclory LsC.arobpiml euallly,hook De /roe knn coibrm Ogan'm`