Rozas Addn-LR050622City of Lewisville Laboratory
Water Bacteriology
Nan~ al Water System
r)
Point of CollecPon Collected By
(Mo/Oay/~r)
Repoding S~EE~
Address c,w ~ ~ ~
TYPE OF .[~ Public [] Individual
SYSTEM: r-'l Other.
SAMPLE
IS:
[] Distribuaan [] Special * [~ Consl~C~Ofl
[] Repeal for sample #
[] Recheck for sample # _
[] Other.
WATER []River ~Lake [~ Well
SOURCE:
Well depth Chl~'ine Residual
ANALYTI~A{= METHC~I3 & RESULTS:
i ~bsent: Total C~iform.,~ Presenl
~TColiler~) E:COli Present
MPN Total Colilorm
! (CalilertI E:Coli
UNSUITABLE FOR ANALYSIS: ( This unsuitabte sampte must be repl~ced wlthln 2 4 h°urs )
[] Foffn ~ncomplete (see attached
[] Sample too old, mot received within 3(] hours of collection
[] Excessive chlorine present in sample
[] Unsuitable coniainer
[] Heaw, non-coliform bacteria/sill present, possibly obscuring and compromising test results
[]Other
Analyzed by