Creekview Add PD-LR071130
I
City of Lewisville LaboratorY -
Water Bacteriolol!Y CJt. f'~ ~ ul eCL/
. I r
( . "1' If () ..\. ;.. D P,'Je f I
Name of Watf1l System
--1){)\\~)
County
Water System Identification Number.
II(g~w6-#- tC!) .1 .,;.. Ih~lq- 07 'l~ 0<<74-
Pomt of Col~clion Colrected By Date Time ~ PM
V . E " t{.... (MoIDaylYr) I
Billing NAME P c." ( 0 '^ s t '\' oJ C. ~ .. () V"I
?O lJo~ 11'4
Address CITY \ ,"'\ [ t~ . .... V\ ,'" ',i
Reporting
STREET
TEXAS 1 ~ ,)~()
(Zip )
lELEPHONE (f1) I ; 6) ... f 1 bJ
l ~ Public o Individual
~ TYPE OF
SYSTEM: o Other I
f SAMPLE D Distribubon D Special g- Construction
t IS:
D Repeat for sample #
! o Recheck for sample #
I D Other
I, WATER DRiver ~ DWell
I SOURCE:
I Well depth Chlorine Residual
~
Absent
/1ooML
/1ooML
Membrane Filler/Fecal Coliform: 111 Oil. _ i _ ml 2nd _1_ ml
Avg, _1_ ml
"
UNSUITABLE FOR ANALYSIS: (This unsuitable sample must be replaced within 24 hours.)
D Form Incomplete (see attac:hed item)
o Sample too old, not neceived within 30 hours of collection
o Excessive chlorine pnesent in sample
o Unsuitable container
o Heavy, non-coliform bacterialsi~ present, possibly obscuring and compromising test resu~s
o Quantity too gneat to pelTlll agitation
o Quantity insufficient for analysis (100 ml minimum)
o Other
M
Analyzed by
Water of satisfactory quality should be fre~ of Coliform Organisms
I""V
c:::J
o
c:.;;;:;,
-.,)
-
Ci;
:i?
lD
..
"
Q.
::l
iil
!If
3
"2-
..
::tl
~
,,'
..
!'1-
(J) ."
.. s;:
~ !;
i I
~ ~
lG
V.:> ~
c::s-
V)
..c-
0 r- r-
.. .. ..
lD ~ j
..
"
Q. 0
::l -<
iil li a
?: ~ z
c
.. 3
~ ("") ~
~
in' Sl. ...
I ~ ~
...
.. 0>
;:! in'
;i
..
to;
:i?
lD
..
&.
....
~.
i
!'1-
()
o
3
3
..
"
!if