Freeport NIP(2.94)-LR070305c� W
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City of Lewisville; laboratory - .
Water Bacteriology 1
Name of Water System County
Water System Identification Number: f //
Point of GOIlectiW Collected tr T ime [J' PIVI
� �(�� (MolDaylYr)
Billing NAME `�"" 4
Reporting STREET 1 / .L) y C,4 4 A ,4 &— JX
�!.lss 1
Address CITY TEXAS
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TELEPHONE (J ��T ?-�
TYPE OF �blic C] Individual
SYSTEM: ❑ Other
SAMPLE ❑ Distribution ❑ Special Construction
IS:
❑ Repeat for sample #
[]Recheck for sample #
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C:
❑ Other
WATER ❑ River ❑ Lake ❑ Well
SOURCE:
Well depth Chlorine Residual
ULTS:
PresentlAbsent Total Cohform Present �Abs-ent o . Present
M.P.N. Total Coldorm 1100ML
(Colilert) E:Coli. 1100ML !"
G
Membrane FilterlFecal Coldortn: 1st Dil. _ I_ ml 2nd —I— ml �
Avg. —I— ml
i
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 chlorine present in sample
❑ Unsuitable container
❑ Heavy, non- coliform bacteria/silt present, possibly obscuring and compromising test results
❑ Quantity too great to permit agitation
❑ Quantity insufficient for analysis (100 ml minimum)
❑Other
Analyzed by
Water of satisfactory quality should be free of Colifonn Organisms
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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 chlorine present in sample
❑ Unsuitable container
❑ Heavy, non- coliform bacteria/silt present, possibly obscuring and compromising test results
❑ Quantity too great to permit agitation
❑ Quantity insufficient for analysis (100 ml minimum)
❑Other
Analyzed by
Water of satisfactory quality should be free of Colifonn Organisms