HomeMy WebLinkAboutWater Bacteriology._.)
WATER BAC ERIOLOGY
Brazos County Health Department
201 North Texas Avenue• Bryan, Texas 77803 • (979) 361-4440
SAMPLE IDENTIFICATION lf/15'(5 Rf ,,,-H-OA4 / /
LABID 48006 SampleNuniberAJ.or&&.-s ubmitted //-/)-c.JZ
MO/DAY/YR
PUBLIC WATER SYSTEM ID 021oooz__ Resulted ·--------Seven cij9ds (REQUIRED) MO/DAY/YR
PUBLIC WATER SYSTEM NAME {_: '?\, {) f ~ L tc: { .Jmvv '
Send cou TY __ ~--~~'=-"'-""--------~-
Sample Name ____ ~::.L.L.l,.f"=~~~.t;..,;J.~;._-------
Results Street Address·----sr-=......:..LJ;L-=-_,':--£-=-=--=----=--
To: City, State, Zip [; '!/z-
Phone __ __,~7~>---;;4~~~c~f-~Y~~f%=~~6~Jo.L-__ · ____ _
-JH-Owner/PWS f ~ 0 ~ Operator ' O Other -.
SAMPLE SITE/COLLECTION DATE and TIME
Date!Time Coilected: //~/) 07 //')8
SYSTEM TYPE SAMPLE TYPE
(Public Systems Only)
WATER SOURCE
0-Public
0 Private/Individual
0 Distribution D Raw: well# __ _ ~C:Sroundwater
(Well) ~Construction 0 Special ____ _
OOther __ _ D Repeat for sample# _______ _ D Other: __________ _
D Surface water
(Lake, River)
DISINFECTANT RESIDUAL (Mandatory) ,((.. -Z: mg/L
Public distribution samples must have a disinfeci:t Residual
Number of samples collected on this date Z-=-
·" LABORATORY REPORT (Do Not Write Below)
~~Chlorine D Chloramine ( Total Chlorine)
Please lndicat::: Test Method Used : Colilert -Presence/Absence
COLIFORM ORGANISMS:
TOTAL COLIFORM D Found ®NOT Found
FECAL COLIFORM/Escherichia coli · D Found C)J NOT Found
REPEATS (required for distribution samples only)
Unsuitable for analysis (see below)
SAMPLE UNSUITABLE FOR ANALYSIS (This unsuitable sample m t be replaced within 24hrs)
0 Sample too old. Not received within 30 hours of collection 0 Heavy SILT/BACTERrNTURBIDITY PRESENT (circle).
0 Quantity insufficier.t for analysis ( 100 ml. required) D Sample leaked in transit
0 Form incomplete I date discrepancy (CIRCLE errors)
0 Other reason· (DESCRIBE)
0 Chlorine residual
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WATER BACtERIOLOGY I()' I ~t}'V\__
Brazos County Health Department ·.
201 North Texas Avenue• Bryan, Texas 77803 • (979) 361-44 0
SAMPLE IDENTIFICATION /)1 !>14~ Vi")( <:htx-,
LABID 48006 SampleNumber6 o :ao. Submitted //;r-oz ~ MO/DAY/YR
PUB LIC WATER SYSTEM ID C/g-'OQCZ-:Resulted. _____ _
Seven digits (REQUIRE~ MO/DAY/YR
PUBLIC WATER SYSTEM NAME 4~ o-< <-0.ut-t..~ J m-ZkJJ
Send . COUNT ---~~~~,,u....:_7~8~?.o=-"'$-------~
Sample Name _____ ~~~c:;,._..:::z..c.~1"«-'=--------
Resu Its Street Add ress. _ __.s,;<-t;..£.-;,-...._-L.,..,__,..,,_,=---~..----=-==-=
To: City, State, ZiP...,..-'-e..?4-~::c-c:'--..J-.~'1:CP.'-1.l.J'-S-~=-~:...J..JL_J
Phone '/7 3tzt::...f
• . ~wner/PWS, D .Operator D OthE;lr
~ '
SAMPLE SITEICOLLECTION DATE and TIME
Date!Time Collected: /// [-O 7 /0 ·c;() ~[J
~ Month)Jay Year Time of Dal 1 ,,,am pm
Sample Site: /n i/f L Cl & } Zii:;;&JthM!J s1'0..J /-?"bte ,-(;n4'./ ~ Address o 'ther description (not sample site number)
Sampler Name/Phone: _ __,~~/,.-4-..._,.;;-....__,HI-.~'-------------
SYSTEM TYPE
ffi'P'U6i i c
D Private/Individual
00ther __ _
SAMPLE TYPE
(Public Systems Only)
D Distrib!,Jtion D Raw: well# __ _
~uction D Special ____ _ D Repeat for sample# _______ _ D Other: ___________ _
WATER SOURCE
~ r0undwater
(Well)
D Surface water
(Lake, River)
DISINFECTANT RESIDUAL (Mandatory) /. SZo mg/L ~ree Chlorine
Public distribution samples must have a disinfe~ Residual
Number of samples collected on this date _ .... ~....-='-'---
l LABORATORY REPORT (Do Not Write Below)
D Chloramine (Total Chlorine)
Please Indicate Test Method Used : Colilert -Presence/Absence
COLIFORM ORGANISMS:
TOTAL COLIFORM D Found NOT Found
FECAL COLIFORM/Escherichia coli D Found r;&_NOT Found
REPEATS (required for distribution samples only)
Unsuitable for analysis (see below)
SAMPLE UNSUITABLE FOR ANALYSIS (This unsuitable sample must be replaced within 24hrs)
0 Sample too old. Not received within 30 hours of collection 0 Heavy SILT/BACTERINTURBIDITY PRESENT (circle).
0 Quantity insufficient for analysis (100 ml. required) D Sample leaked in transit
0 Form incomplete I date discrepancy (CIRCLE errors)
0 Othar reason· (DESCRIBE)
D Chlorine residual
WATER BACTERIOLOGY
Brazos County Health Department
201 North Texas Avenue • Bryan, Texas 77803 • (979) 361-4440
SAMPLE IDENTIFICATION 2 1 -
LAB ID 48006 Sample Number 11' ? .. ') Submitted J -/if~! ;'/
I MOIDAYIYtJ._
PUBLIC WATER SYSTEM ID 0 2 f C>Do .' Resulted -/ S ( · J
Seven d191ts (REQUIRED) MO/DAY/YR
PUBLIC WATER SYSTEM NAME I -), Gil( I /f. Send COUNTY -,-'-:-,~~-~~,-'-'-'-'-~..:...:...!.-______ _
Sample Name r,:, rri, (,1j1 (I
Res~lts Street Address fo~o.r 094'(,o To. City, State, Zip-Cl7s"":~::::t'l£~""7~'/~ll..5.<"Ll·.L~.---------
Phone c, 7'i · /(,,ti -1&? 1
0 Owner/P,WS C}-eJperator O Other
SAMPLE SITE/COLLECTION DATE and TIME
Dateffime Collected: TA tU It/ ?Cb R
· MoR(h bay Year
Sample Site: "-1 r11-._.11/k"' 1 ill'
0 am pm Time of Day
~h . _7 Addres5tofol/)er de,scription (notpa SamplerName/Phone: u"? .:..1./ ?""" ~ /tt>Jr\l/(;f1./
l
SYSTEM TYPE
0Public
0 Private/Individual
O Other __ _
SAMPLE TYPE
(Public Systems Only)
D Distribution D Raw: well#
Gfrconstruction D Special ---
0 Repeat for sample# 0 Other: -------
pjt}s1te numbo/) ~ l(...Jc~ Hµ'1...
WATER SOURCE
[J"Groundwater
(Well)
D Surface water
(Lake, River)
DISINFECTANT RESIDUAL (Mandatory) ! tl ; mg/L
Public distribution samples must have a disinfectant Residual
Q ree Chlorine
Number of samples collected on this date _ _,,.., ___ _ 0 Chloramine (Total Chlorine)
I LABORATORY REPORT (Do Not Write Below)
Please Indicate Test Method Used : Colilert -Presence/Absence
COLIFORM ORGAN ISMS:
TOTAL COLIFORM
0 Found NOT Found
FECAL COLIFORM/Escherichia coli
0 Found NOT Found
REPEATS (required for distributfon samples only)
Unsuitable for analysis (see below) Analyst Initials: ~
SAMPLE UNSUITABLE FOR ANALYSIS (This unsuitable sample :?ust be replaced within 24hrs)
0 Sample too old. Not received within 30 hours of collection 0 Heavy SILT/BACTERIAfTURBIDITY PRESENT (circle).
0 Quantity insufficient for analysis ( 100 ml. required) 0 Sample leaked in transit
0 Form incomplete I date discrepancy (CIRCLE errors) 0 Chlorine residual
0 Other reason: (DESCRIBE)
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I
WATEFiBACTERIOLOGY (}. 1
Brazos County Health Department ~ .:;l1(J ik--
201 North Texas Avenue• Bryan, Texas 77803 • (979) 361 -4440
SAMPLE IDENTIFICATION -1...1 ( (J
LAB ID 48006 Sample Number '_A O,''J Submitted / /'-J.J.J9
I MOIDAYIYRO
PUBLIC WATER SYSTEM ID OZ./()002 Resulted ·/ $.{)}
Sevendigits(REOUIR D) ___ M_O_VD_A_Y.,,.'/Y"-R__._
PUBLIC WATER SYSTEM NAME 0t'1 't ,.,{' (!~ 5!11Tla.J
Send ·~ CO,UNTY_f?A~A~2o~S ________ _
Sample Name Vvfb'! {;A/l_O.iJ
Results Street Add ress_.._P_,D"----"P,ll .... i'-'--_,_99~fo0£...L..<D'----------
To: City, Sta~._ Zip _es f)' -71 zv -
Phone . .; JCJ • Z l. l/ i {, t ?
O Owner/PWS D Operator 0 Other
SAMPLE SITE/COLLECTION DATE and TIME
Date/Time Collected: 11t.AJ ) i . 'lob 1 IL· to "" D JJ Montf>.pay_Year , /
Sample Site: f'-{tkA. U'1K S 1-t"/D Time of Day am pm
1 · . , A . Address O{ ofller description (not sample· site number)
Sampler Name/Phone: 1 ID 1i.,. . s4 ; -1 ""'· . I -
SYSTEM TYPE
EtP'ublic
0 Pri vate/Individual
00ther __ _
SAMPLE TYPE
(Public Systems Only)
0 Distribution D Raw: well# __ _
Q onstruction 0 Special. ___ _
0 Repeat for sample# ______ _
0 Other: ___________ _
WATER SOURCE
0 Groundwater
(Well)
0 Surface water
(Lake, River)
DISINFECTANT RES IDUAL (Mandatory) £. '/ L mg/L
Public distribution samples must have a disinfectant Residual
G;r ree Chlorine
0 Chloramine ( Total Chlorine)
Number of samples collected on this date __ 7 ____ _
LABORATORY REPORT (Do Not Write Below)
Please Indicate Test Method Used : Colilert -Presence/Absence
COLIFORM ORGANISMS:
TOTAL COLIFORM D Found NOT Found
FECAL COLIFORM/Escherichia coli
0 Found OT Found
REPEATS (required for distribution amples only)
Unsuitable for analysis (see below)
SAMPLE UNSUITA BLE FOR ANALYSIS (This unsuitable sample must be replaced within 24hrs)
0 Sample too old. Not received within 30 hours of collection 0 Heavy SILTIBACTERIAfTURBIDITY PRESENT (circle).
0 Quantity insufficient for analysis ( 100 ml. required) 0 Sample leaked in transit
0 Form incomplete I date discrepancy (CIRCLE errors) 0 Chlorine residual
0 Other.reason: (DESCRIBE)