Freeport NIP(7.1)-LR000828 Polnl of ~i~ ~l~By
"~"~"~ smelt ~ I ~ ~ F~ / ~ ~ ~. ,
~ R~al ~r ~p~ ~. '
~ R~ ~r ~ple
~r
WA~R R~r '~L~ ~ We~
SOURCE: ~11
ANAL~ICAL METHOD & RESULTS:
~resenFAh~Ant- T~tal Col~ ~ Present
(C~ile~) ~:~ Presenl
M.P.N. Total ~li~ ~ I1~
(~liled) E. C~i.
Unsuitable For Analysis:
I--] Fonn Incompkl~ (~ ancircMd item) ~T '
[] Saenple too old, ilol received within 30 houls of colteclk~
[] E~,,,,~e chleme i=eaer~ In sumple ro
[] U~ultable ~
[] Heavy. non ed/loire baclel/a/sill pmsunL possibly obs~ and compromising lest results
[] Quantity too gnmt to pemVA aotlaUon
[]~ o,,.,~y ~.,,~<~,~ ~.,~,ly.~ (lOO ,~ n~r.,,=) o~.~
CITY OF LEWISVlll~ LABORATORY - WATER BACITcRIOLOGY
· me o! W~IM System County
Point of 061ecflon Collected By T~ (IVfo/Day/Yr)
B,,ng/ NAME0('C~ /L/~t ~-
TELEPHONEIC~Z ~ ~ *~ ~ "~E~ (Z]pCem)
Water ~em ~t~ti~ Numar
TYPE ~i~.bli~
OF
SYSTEM: [] Other
[] Individual
SAMPLE r-I Distribution D Special
IS:
D Repeal fo~ sample it
[] Recl'mck for sample #
~ Other.
~onstruntion
WATER [] River Lake [] Well
SOURCE:
~vY'~c-AI METHOD & RESULTS:
____'r_q.s t/Absent: Total Colif_oor m~ Present
(Colilert) E:Coh~ -- Pmsem Absent
M.P.N. Total Coliform /10
/10
(Colilert) E. CoIL
Membrane FilterlFecal Col#otto: 1st DiL I
Unsuitable For Analysis: --;
[] Form Incoml~le (see undrcled #em) "" '
[] Sampb Ioo okJ, mX mcebed within 30 houm of ce#ectkm
[] u,~ ~,~
[] Heavy, non a:~ I)~clWMit present, possibly obecuridg and Cmnlxomising lesl malts
[] Quantly tm) ~eal to pefmll agilalion
CITY OF IL~'WISVILLE LABORATORY - WATER BACTERIOLOGY
Point of Coll~tkm
County
~-~ , · (Mo/Day/Yr)
Repo~ting STREET--~-r' "'~L.~' ~4"~* ~ /-./-r?/"' ~-
TI:LEPHONE~'~/7~' ) l?:'~ ~'~'// (ZIpCo~e)
Wata~ Sy~em lo. II.fen Number
TYPE ~Pub#c [] Individual
OF
SYSTEM: I-1 Othe~
SAMPLE ["1 Dbtribution i-"l Special Ill'Construction
IS:
[] Rapeat for sample #
[] Recheck for sample #
r-] 01her.
WATER
[] River ~Loke [] WoN
SOURCE:
Wall depth// ' Chlorina Residual
ANALYTICAL METHOD & RESULTS:
.~nt/Absent: Total Coliform~ Present
(Colilert) ~:c,u.. Present
M.P.N. Total Coliform
(Colilert) E. CoIL
Avg. I_ mi
Unsuitable For Analysis: .-7;
~-I Form Incom~ele (see andre#ed item) '"- '
[] Sen~plo too oki, no~ received v~thin 30 hours of oo#ecaou I'~
I-] Ex _,~,,,~. chlo~e ix'eesnl in sarn~
[] ur~w~ ~x~ar~
[] Heavy. nou =oitlmm bacleda/sitl pmsant, possibly obsct~ng and compromising tes~ msulls
[] QuanUly IOO grest fo pefml agitatior~
[][] QuanU~ kmulfldanl far analysis (100 mlminmUm)other -~/~VvII/
Analyzed by .
CITY OF I~'WISVILLE LABORATORY - WATER BACTF. RIOLOGY
· ~,dme oFWaler System County
,.-.. .~(Mo/Day/Yr)
STREE".['~'~)~'~ ('~c~"~ ~" '~ · _1
TELEPHONE~7___) (~<~ ~'~6 (~pCode)
Rapo~ling
Address:
Water System Idoflflflcalio~ N~Jmber
TYPE [] Public
OF
SYSTEM: I-I O~har
~Tndividual
SAMPLE [] D~ribution [] Special ~Construclion
IS:
[] Repeat for ~ampte #
[] Recheck for sample #
WATER [] Rival ~Lake I--I
Well
SOURCE:
Welt depth // ,
ANALYTIOAL METHOD & RESULTS:
Total CoJiform~ Present
(Colilert) E:COIi. Present
M.P.N. Total Coliform
(Colilert) E. CoIL
Membra ne Edt e r/Fecal Colifo tm: 1st •il.__/
Unsuitable For Analysis: -'~..
[] Form Inc~e (~e encircled #em) ,-'7 i
[] Smnple too old, ne~ received wllhln 30 houm of collection ... ,
I--1 ~,'~,~'e chk~me prenem in sample
[]
[] Heavy, non co#form bacleria/,.Jll present, possibly obscuring and comlxornlsing lest results
[] Quamay too gmat to portal aotaien
CITY OF LEWISVILLE LABORA.TORY - WATER BACTERIOLOGY
~o! Wal~ Sy~m County
Point of Collection Tt
TELEP~NE~) ~ ~ g~ (~)
Water SyMem Idenfl~c&tlon Numbs'
TYPE [~P;:lic r-~ Individual
OF
SYSTEM: i-"l O~her
SAMPLE
O DIIIribution I--I Special ~"'conslnlction
IS:
I'-I Repeat for sample #
[] Recheck for sample it
WATER I-I River ~ake I-I Well
SOURCE:
Welt deP{h/tr \ Chlodne Residual
ANALYTICAL METHOD & RESULTS:
,~Absent: Total Coliform ~) Present
(Colilert) E:Coli. Present
M.P.N. Total Coliform
(Colilefl) E. Coll.
Membmrm Filt erlFecat Co# fo~m: 1st Dil. I___
Avg. I mi
Unsuitable For Analysis: ,';7 '
[-I Form tncoml~e (~ee endtcl~ itam) _.,
[] Sempl~ too (dd, no~ mcmlvm:l vY4hin 30 hours of collection ~
[] Heaw. non o011lo~m bacta~s/si# present, possibly ol)act~ng and com~omislng lest results
[] Querally 1oo great to i~'rnl a~elion
[]OtherDQUan~'~Jadem~"na~/~isOOO~mlnmum) ~ ~ ~