Freeport NIP(7.5)-LR010613W&ter System Identlflc~Uon Number
~PE ~P~ ~l~al ~" ~ ~- - -
OF
SYSTEM: ~
SAMPLE ~ D~t~n ~ S~i81 ~ Con~n
IS:
~ ~ we~WA~
[,%
-)
CITY OF I, EWISVll ! F LABORA'rO~Y - WATER BACTERIOLOGY
Name of Water Symem County
Point of ~ ~,'1~ ~1~ By Dmt Ti~
* * (M~y~r)
Billing/ NAME,-~
Addrees: STREET.
TELEPHONE(
TYPE {~"Publlc [:3 Individual
OF
SYSTEM: ["1 Other
SAMPLE I-3 Omrlbmlon I-I Special r-I Con.ruction
IS:
D Repeat fro'
r-I Recheck ~or sample #
r"] Other.
WATER E' ~.~. _ [~ Lake I-I Well
S -
I~E W®II ~ .Chlorine Residual _
~NALYTICAL METI:iQ~r.& RESULTS: -
resenVA~sent: Total Present
(Colilert) E.'Co!j~- --- Presenl ~- Absent
M.P.N. Tota~__mllform U10OML
Avg. /____mi
Unsuttab~ For Analysis:
[] S~ I~0 dd. no~ ~re=eived M~hln 30 h~r~ of m~:~l
TYPE
OF []~'Pubac. I--I IndivlduaJ
SAMPLE
Is:
WATER
Well depth
RESULTS:
M.P.N.
(Colile~l) Total Coliform
E, CoIL
Membrane F~ter/Fecal Coliform:
Avg.~__ml