Northlake 635(4)-LR010109 TARRANT COUNTY PUBLIC HEALTH LABORATORY
..... ~. . · 1800 University Dr., Ft. Worth, TX 76107
AO ~ WATER BACTEI'IIuLuGY LabNO. 48010 1817)871-7245
.' / / NAMEOFWATERSYSTEM [ I I I I I
,,o__s__- w.._,.,..
~1~ ~ D~ Y~ ~ME A~M ~ ~
WATER SOURCE
~ ~PE OF SYS~M S~PLE IS
~1~ ~ ~t~t~ ~R~t ~W~
~ ~V~ ~G~ol/Sw~tlC~ W~m Wd
~ Y . ~ .BORAT~ R~O~ ~ no mb..
~_~..... · ~ I I~
[] Not Found
Total Coiifon~100 mi
E. co/i/ l O0 mi
~m:al CordomlsllO0 mi
UNSUITABLE FOR ANALYSIS-PLEASE RESUBMit [] Ouaotity i~pllflckmt fm analysis
it00 nd, requke~)
[] Hea~ (silt~oectmiaJ ~rowth| p~esmtt,
Totld
Co6fon~ MPNIIOOml
E.c~: MPNI100mi
"'] U~sble -- See below
possibly comprondsin9 te~t results .
[] Sm~ r~ml oo F~day
[]
TARRANT COUNTY PUBLIC HEALTH LABORATORY
1800 University Or., Ft. Worth, TX 76107
WATER BACTERIOLOGY Lob No. 48010 1817)871-7246
Do Not ~rk Abo~ This Line--P~se Print hl~ ~th BRLLPOI~ P~ OR ~P~ER:
Thmef
' I ' IAMEOFWATERSYSTEM
/,q ? ?- c.d
fliNT OF COLLECTION/SAMPLE DESCRIPTION
IAIE
sE.o / tD? Fm/ s
RESULTS STRETT ADDRESS fP.0. Sexl
Coil&de. Month Day Yi TIME AI~PM
T~PE OF SYSTEM SAMPLE IS
~ruldic i'-'lOairy r-IOistributiee r-INow
I-IIn~rr,~dud r-INottkd '"'E~ Coflstruction[-'lRepeit
r-IScheol l-Wended F'lGIycoUSweetlChtl
r-lothe
~ ~'....' _~._ Infonuation:
LABORATORY .e~ki Wo nl wdtl hdllil
Water System I.D. No.
Membrane Filtration
~if~ O~i ~ff~ Or~im
F'T~et Fi eed [] Not Fomal
[] Total Colifemdl00 nd
[] E. co/~ 100 nd
[] Fecal Cdffem~sll O0 nd
, -- See below [] Unsuitable -- See below
ILRiSUITABLE FOR ANALYSIS-PLEASE KE'~Ullt t
[] Saflt~tmMd. S~denot~ek.M
within 30 hours of cekction
[] Date discrepancy or finn incomplete
[] L/md b trmdt
[] (]uidity too ~rlmt to pemM agitldm
[] Excesdve ddodm rL~ml: rr~/L
I, l?l,'fl
CMleeted 0¥
WATER S~S~E
r--IRi~
~w~
wd O~
C~ ~
TEC~
MMO-MUG
(MPN)
[] Not Feeed
Tetd
Cerlfmm: MPN/1OOnd
~co//:. MPN/1OOnd
[] Unsuitable -- See below
[] Ouantity bsulficient fo~ analysis
[] Heavy (s~t~'oactmiel growth) i~eSmlt,
poss~T~y clsmgroo~sie9 test results
[] Sanl~e received oo Friday
H-220 GP~-219~
TARRANT COUNTY PUBLIC HEALTH LABORATORY
1800 University Dr. Ft, Worth, TX 76107
WATER BACTERIOLOGY LabNo. 48,01,0~-, 18171871.7245
Oate and Tkmi ~';~ '? ~-i ' '[ ~" ' ' ~ ' Oa~e
Smr4de f~V; L...~ ~... '~" RepmtKI
go Nat Mark Above This Line--Ptease Print Below wtlh BALLPOINT PEN OR TYPEWRITER:
NAME OF WATER SYSTEM
IIIIIIII
POINT OF COLLECTION/SAMPLE DESCRIPTION Warm System LO.
Dltl and
Thee of
Coflecdon
(Zi~ Cmiel
Month Day year TIME AM/PM Cellectml By
TYPE OF SYSTEM SAMPLE IS WATEI~OURCE
-'"t~Puldic r-lOaby DDistr~Jtien I--IRaw [-Iniver
r-hndividual I--IBottlnd '"'""E~ Cemtmctim DRepeat I-]Well
DSchoel DVeaded r~ 61ycel/SweotlCldll Water Wdl Depth
[]Other Clderbe Residual
MMO-M ; Membrane Filtration {FAF) M -
PreseneelA Bnce Mm Probable Number (MPN)
Cdifmm Orglnlmoa CeUfarm Organisms , CMUarm Organ~
~F~FOund ~ r-~ Not Found [--I Found Dr'eundi-1 Not Fomd
~ [] Total ~rdorm group Total Calife~lOO nd Total
~ [] E~,~cdi E. co/~'lOOnd Cordon,A: MPNIIOOnd
~k,=~},dll~mt sanples mquifnd Fecd ColiformsilO0 nd E.~/~. MPN/IOOnd
LT,Unsuit&ble -- See below [] Unsuitable -. See below D Unsuitable -- See below
UNSUITABLE FOR ANALYSIS-PLEASE RESUBMIT
[] OImetity insufr~Hent fe~ afmlysis
(100 mi. required)
[] Heevy (sgt~bectmial OrewIN pfemlt,
possi~y co(rl~eetisi~g test result s
[] sm~e rece~d on Fdday
H-220 GPC-2190