Denton Tap 3A-LR060222City of Lewisv. ille Labora~or~ -~ ¢;r~/?~v ~
Water Bactenolo~ "N ~/~P~.r~ ~
TYPE OF [~"Public []lndiv~u~
SYSTEM: [-] O~er.
SAMPLE [] Disb~buboe [] Special [~'~(~.~nstructJon
IS:
WATER
SOURCE:
.~'
[] River [~ake [] W~l
M.RN Total Co4i~3rm -- I100ML
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be replaced within 24 hours.)
[] Form Ince. mplete (see attached item)
[] Other