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Valley R Baptist 2-LR030305
Syslem County. / , -, . .-h' '~' ^~'~"~:' Poinl of Collection Collecled By ~e Ti~ (M~D~r) NAM~E ~ TELEP~E[~) Water ~ ~n Nu~r . .~TYPE [] Public [] Individual ' ~ OF ~.. SYSTEM: I-I Olhel' SAMPLE f-I Distribution [::]~.~cial ~..Conslruction IS: ~--~ Ref)eat for sample ~"~ ~ : [--~ Rechec~x for sample i¢ WATER ~-I River . [] Lake '°: r~ Well ~. ~,F~f ¢. ~-~ SOURCE:. we. dep~, ~ Chlorine Residual ~-~ /100ML IICOML ANA_.~_.L~ICAL METHO~ & RESULTS: (Colilert) E:~. ~ Present MEN TO~I ~o~ (~ile~) E, C~i. Avg I mi Unsuitable For Analysis: [] Fon'n Incomp~me (see encircled item) [] Sample too old, n~ received within 30 hm~rs of collection [] Un~Jaab~ eor4aine~ [::] Heavy, no~ oolik)rm bacteria/sill present, possibly obscuring and coml~omis~ng tea results [:::] Quame/mo gmat to permit a~io~ J--I Quantity in~ fo~ analysis (100 mi minmum) ^na~yzed ~