Gateway BP(1.6)-LR061004 (2)~i~tv of~s~Ti[e-[.aa~oratorv
Water Bacteriolo~v
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Na Water System a County
Water ~yslem Id ~Gfigation Number:
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ant o o eCtbn ect y Date Time ~~l PM
Billing NAME ~J
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Reporting STREET 1
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Address ~
clTV TexAS
(Zip Code)
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TELEPHONE IL~~ 1 V / ~ ~ - ~ ~~
TYPE OF Public ^Irxlividual
SYSTEM: ^ ther ~` ~~
SAMPLE ^ Distribution ^ Special Corrstruction
IS:
4 Repeat fa sample #
^ Recheck for sample #
^ Odler
WATER ^ River ake ^ Well
SOURCE:
Well depth Chlorine Residual
ANALYTICAL METHOD 6 RESULTS:
PresenUAbsent: Total Cdi~ Present
(Colilert) Cdi. Present Absent
M.P.N. Total Cobform I10pML
(Colilert) E:Cdi. It00ML
Membrane FdledFecai Coliform 15l Dd _ I _ ml 2nd _ I _ ml
Avg -I_ ml
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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 mirnmum)
^ Other
Analyzed by
Water of satisfactory quality should be free of Coliform Organisms
~it~ o~eu~s~it~~7a~oratorv > ~ 3 R
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Water Bacteriology ~~ 3
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Water System Ide fication Number: `
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Billing NAME
Reporting STREET ~ ~ 1 ~ ~ ~, ~~~i.,~,~ \ ,`~' ~ ~ ~ g
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Address clTV t ~ ~"' (~'` ~D21 vJG ; TExAS ~ S ~x 4 ~
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(Zip Cade) ~ ~ O
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TELEPHONE (1 ~.~j 1 t 7 ~ ~ ~ ~ ~ ~
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TYPE OF ,Public ^tndividual G+ J
~'`"' N O
SYSTEM: ~ ^ Other _, u
SAMPLE ^ Distribution ^ Specal Conswdion C~.~
~,
IS:
^ Repeat for sample # '
^ Recheck fa sample # " "
^ Other F"" ° ~
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:
WATER ^ River lake ^ Well
SOURCE: ''
Well depth Chlorine Residual ~
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L a 8
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ANALYTICAL METHOD 8 RESULTS:
- Piesent~Absent: 4 Total Col~ohn Present JChgent a t ^•
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(C-oTife'rTj'~- --"-'-F~oT. Present Absent
M.P.N. Total Coliform I100ML ~,~
(Colilert) E:Coli. 1100ML CJ':
Membrane FilterlFecal Coliform: 1st Dil. _/_ ml 2nd _/_ ml
Avg. _I_ ml .._- ~
I ~
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be replaced wdhin 24 hours.) CA
^ Fonn Incomplete (see attached item)
^ Sample too old, not received within 30 hours of coflection
^ Excessive chlorine present in sample
^ Unsuitable container
^ Heavy, non-Coliform bacterialsilt present, possibly obscuring and compromising test results
^ Quantity too great to permit agitation
^ Quantity insu~cient for analysis (100 ml minimum)
^ Owr
Analyzed by
Water of satisfactory quality should be free of Coliform Organisms
~~~f ~~~~~borators+ -~~~ ~ ~
i s+ o Le is ille
Water Bacteriolo~+ :-
j N me of Water Systel~ County
Water System Ide bQ f~ation Number:
~ J ~r
Dint o ollection o~lfec~y to Time L4pol PM
Billing NAME ~~ ~ ~ '"
~ l I t~ i `d L I~ KL~ ~u~.~ ~'
Reporting STREET
Address an ~ f{ ~ ~ l~x~.s rExAS - - ~ r ~ ~~
i
(Zip Code}
TELEPHONE (_ _ 1__ - - ___ _
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TYPE OF ~Rublic ^Individual
SYSTEM: ^ Other
SAMPLE ^ Distribution ^ Special Construction
. IS:
^ Repeat fa sample #
^ Recheck fa sample #
^Other _ _-y ..
WATER ^ River ~`] Lake ^ Well
SOURCE:
Well depth L`hlorine Residual
~ANALY-TJ6A6
~resenUAbsent: A~I~THE3B~&'`R_E~SULTS:
Totalywuurm Present
~\
(Colilert) E:Cdi. Present Absetlt~
M.P.N. Total Colifam 1100ML
(Colilert) E:Coli. lt00ML
Membrane FAterrFecai Cohrorm: ist Dn _ 1_ ml 2rd _ / _ ml
Avy ~/~ ml
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UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be replaced within 24 hours.)
^ Form Incomplete (see attached item)
^ Sample loo old, not received within 30 hours of collection
^ Excessive chlaine present in sample
^ Unsuitable container
^ Heavy, non-coli(orm bacterialsilt present, possibly obscuring and compromising test results
^ Quantity too great to permit agitatbn
^ Quantity insufficient for analysis (100 ml minimum}
^ Other
Analyzed by
Water of satisfactory quality should be tree of Coliform Organisms
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