Belt Line Trade-LR060719
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City of LewisviUe Laboratory .~ = r
Water BacterioloSY " , lla:N~
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, of Water System
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Water System Identification Number:
wP~~ o(iJtc.K(~1 C~~y
7-/7:(lt 1/ 7() ,
Date . TIme !:;I PM
(MoiDaylYr) .'
Billing
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STREET ..st-Io (UhJ,I)? "..- r /'
CITY 5.,1 v -H / ~ /~C TEXAS
76'0'9.J
(Zip Code)
NAME
Reporting
Address
r ],1 A _ ("/ u. .?,'
TELEPHONE ( j I h .L J,:z. _
TYPE OF
SYSTEM:
[] Public
D Other
D Individual
SAMPLE
IS:
D Distribution
D Special ;,;;J Construction
o Repeat for sample #
D Recheck for sample #
o Other
WATER
SOURCE.
DRiver
~WeU
D Lake
Well depth
Chlorine Residual
~l U~~i:~
t Total Colifo s
Ie .v . s nt
M.P.N. Total Coliform
(C~ilert) E:Coli.
~T:'
/100ML
'/100ML
Membrane FillerlFecal CoI~onn: 1st Oil. _ 1_
mi 2nd _1_ ml
Avg. _1_ ml
4
..
UNSUITABLE FOR ANALYSIS: (This unsuitable sample mustbe replaced within 24 hours.)
D Form Incomplete (see attached item)
D Sample too old, not received within 30 hours of collection
D Excessive chlorine present in sample
D Unsuitable container
D Heavy, non.coIWorm bacteria/slit present, possibly obscuring and compromising test results
D Quantity too great to permit agitation
D Quantity insufficient for analysis (100 ml minimum)
D Other
o
1!~'
Analyzed by .
Water of satisfactory quality should be free of Coliform Organisms
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City of Lewisville Laboratoryl"-"
Water Bacterioloi!Y 1
C I ~ 01 C ~/.:7J1R If
Name of W er System / ( County
Water System Identification Number.
M .., r~. ,)/- ( .)171// IIi
Point of ollection / Collect y
Billing
Reporting
Address
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Date Time
(MoIDaylYr)
'AM '?M
, .
NAME
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STREET
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CITY
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71-,) '1J
(Zip Code)
TEXAS
TELEPHONE
TYPE OF I,;W'Public Dlndividual
SYSTEM: D Other
SAMPLE D Distribution D Special JX Construction
IS:
D Repeat for sample #
D Recheck for sample #
D Other
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UNSUITABLE FOR ANALYSIS. (This unsuitable sample must be replaced within 24 hours.)
D Form Incomplete (see attached item)
D Sample too old. not received within 30 hours of collection
D Excessive chlorine present in sample
D Unsuitable container
D Heavy, non-coliform bacteria/silt present. possibly obscuring and corejlromising test resu~s
D Quantity too great to permitagitation
DQuantity insufficient for analysis (100 ml minimum)
D Other
~v
Analyzed by
Water of satisfactory quality should be free of Coliform Organisms