Freeport NIP(2.8)-LR040716City of Lewisville Laboratory
Water BacteriolOgy
/~/f Name of Water System
Water System Iden~fication Number
Pant of Cofleofion Colleofed By
Address C~T~/' 14~:-3, ~ LC
/
TELEPH~E
County
TEXAS
(ZlpCOde)
TYPE OF ~blta
SYSTEM:
SAMPLE
WATER [] ~ve~
SOURCE:
Constr~Jm~
IIOOML
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be reCaced within 24 hours.)
[] Form Incomptele (see auached item) ~ ;
Analyzed by
City of Lewisville Laboratory
Water BacteriologY
Point of Collection Cofleofed Sy
Repoding
Address
TYPE OF [~ub~ [] Individuof
SYSTEM: [] Other
SAMPLE
IS:
[] Distribution [] Special ~""'~onsb'ucbon
[] Recheck for samCe #
[] Other
WATER [:]River [~'[~ DWell
SOURCE: -'
Well depth Chlonne Residual
A N A LY T I CJ~_M,E,T. MO~&.I~U LT S:
,~r. esent/A~sent Total Cofdorm ,) Present ~
(Collier[) E:COfi Present Absenl
M.P.N Totta Coliform /fOOML ~ -
(Coltiert) E:Coli IfOOML
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must ~e replaced withm 24 hours,)
[] Form Incomplete (see attached gem)
[] Sample too old, not received wiLhin 30 hours of coftaction
[] Excessive chlorine present in sample
[] Unsuitable conlainer -
[] Heavy, non-coliform bactena/tag present, possibly obscuring and c~mpro~ising leta results
[] Quantity too great to permit agitation
[] Quantity insufficient for analysis (100 mi minimum) ]'~
[] Other ~
Analyzed by
Water of satisfactory quatity sh~ld be free of Coliform Orgamsms
City of Lewisville L_aboratory~
Water Bacteriology
~//,r 'Name of Water System
Point of Col~ect~n Collected By
County
(M~/DayWr)
Reporting STREET /~
Address ClTY'~'~'////r ~ ~*"{.'~--'*--~ TEXAS
/
SYSTEM: ~ ~er
SAMPLE
IS:
[] Other
WATER [] Paver [~[~a k e [] W~I
SOURCE:
Well deplh Chlonne ResiduaTL
ANALYTICAl MI:THC~I3 & RESULTS:
M.RN Tota~ C~iform __/100ML
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be replaced within 24 hours.)
[] Form Incomplete (see attached item)
[] Sample too old, not received within 30 hours of collecbon -
[] Other
Analyzed by
City of Lewisville Laboratory -
Water Bacteriology
Water System Ide~cahon Number:
Billing
Address
County
TYPE OF ]ledwidual
SYSTEM: []
SAMPLE
)S:
[ f~ sample
WATER []
SOURCE:
Weil depth__
~]Ouantit~
[] Other