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Creekview E21P-LR010321
~!'I~' OF I~WlSVIL! F I.J~OR~TOR¥ - WATER BAClE. RIOLOG¥ Reporting Address: ,. Point of Collection Colleoted By Date ~ " (Mo/Day/Yr) TELEPHONE( ) ~ Water Syatem IdontiiJc~tlon Numb~ SYSTEM: LJ Other. SAMPLE [] D~ribution [] Special [] Repeat for samp~ # [] Recheck for sample # ' [~ Other. WATER [] River ~ake [] Well SOURCE: -- We~l deplh , Chloflne Residual ESULTS: Present (Colilert) E:COlL Present M.EN. Total Coliform (Coltlert) E. Coll. Membra~ J=ilt er/F®cal Coliform: 1st DiL / JIOOML Avg. /____mi Unsuitable Fm Analysis: [] Fom~ I~ (sae encircled item) O ' ~ H~W, n~ ~ ~ ~t, ~ o~dng ~d ~r~ng tea ~ Q~ t~ ~ to ~ a~ ~'~ ~ ~ Q~ ~ ~ ~ (1 ~ ~ ~n~m) ~ ~r