Historic Coppell-LR060428"r19
City of Lewisville Laboratory
Water Bacteriology
Co, L iLas
Name of Water System County
Water System Identification Number
oint of o Ion Collee ed By
o6
Date Time M
(MolDayf Yr) a
Billing NAME 7( re L i p e. e f I
Reporting STREET P D 551:.6 0 q 7g O
Address CITY We is4 TEXAS 74/40
TELEPHONE *..1/4 1 7 5 I
TYPE OF t Pubic Individual
SYSTEM: Other
SAMPLE Distribution Special E t Construction
IS.
WATER River Quake Well
SOURCE.
Well depth Chlorine Residual
resent/Absent: Total Conform Present
(Cdilert) E:Coli. Present Absent
M.PN. Total Coliform /100ML
(Colder() E:Coli. 1IOOML
Membrane Filter/Fecal Cddmm IMO! I_ ml Tnd ml
Avg. mt
(Zip Code)
Repeat for sample
Recheck for sample
Other
UNSUITABLE FOR ANALYSIS. (This unsuitable sample must be replaced within 24 hours.)
Form Incomplete (see attached item)
Sample too old, not received within 30 hours of collection
Excessive chtonne present in sample
Unsuitable container
Heavy, non-conform bactenalsdl present, possibly obscuring and compromising test results
Quantity too great to permit agitation
Quantity insufficient for analysis (100 ml minimum)
Other I
1
Analyzed by
Water of satisfactory quality should be free of Coldorm Organisms