HomeMy WebLinkAboutM25F0121 AmTest Bacteria FINAL 20250613 RPT 01AmTest Laboratories
13600 NE 126th Place Suite C, Kirkland, WA 98034
(425) 885-1664 www.amtestlab.com
COLIFORM BACTERIA ANALYSIS FORM
E. coli present E. coli absent
Date Sample Collected
06/11/2025
Month Day Year
Time Sample Collected
8:25 am
County
King
Type of Water System (check only one box)
Group A Group B Other
Group A and Group B Systems - Provide from Water Facilities Inventory (WFI):
ID#: 71850L
System Name: City of Renton
Contact Person: Abdoul Gafour
Day Phone: (425) 430-7210
Email: agafour@rentonwa.gov
Cell Phone: (425) 282-2573
Send results to: (Print full name, address and zip code or e-mail)
City of Renton, 1055 Grady Way Renton, WA 98057
SAMPLE INFORMATION
Sample collected by (name): Casey Grant
Specific location where sample collected: 1012 SW 4th Pl Special instructions or comments: New hydrant C25001798
Type of Sample (select only one type of sample from types 1 through 5 below)
1. Routine Distribution Sample (A/P)
Chlorinated:Yes No
Chlorine Residual:
2. Repeat Samples (A/P)
(from distribution system after unsat. routine)
Unsatisfactory routine lab number:
Unsatisfactory routine collect date:
Chlorinated:Yes No
Chlorine Residual:
3. Ground Water Rule Source Sample
Triggered (A/P)
Assessment (A/P)
4. Surface or GWI Raw Water Sample (Enumeration)
E. Coli Fecal Filtered: Yes No
5. Sample collected for Information Only:
LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY
Unsatisfactory Satisfactory
Date/Time Received: 6/11/2025 2:27:00PM
Receipt Temp (C): 26.5 C
Date Reported: 06/13/2025
DOH Lab- Sample# 0660-M25F0121-01
Lab Reference Number: M25F0121-01
Method Code: SM 9223 B (Presence/Absence), SM 9223 B
(Presence/Absence), ,
Lab Use Only:
Total:
Free:
Total:
Free:
|__|
Bacterial Density Results:Total Coliform: Absent/100mL E. coli: Absent/100mL
Fecal Coliform: NA/100mL HPC: NA/1mL
Total Coliform ABSENT and
AmTest Laboratories
13600 NE 126th Place Suite C, Kirkland, WA 98034
(425) 885-1664 www.amtestlab.com
COLIFORM BACTERIA ANALYSIS FORM
E. coli present E. coli absent
Date Sample Collected
06/11/2025
Month Day Year
Time Sample Collected
8:40 am
County
King
Type of Water System (check only one box)
Group A Group B Other
Group A and Group B Systems - Provide from Water Facilities Inventory (WFI):
ID#: 71850L
System Name: City of Renton
Contact Person: Abdoul Gafour
Day Phone: (425) 430-7210
Email: agafour@rentonwa.gov
Cell Phone: (425) 282-2573
Send results to: (Print full name, address and zip code or e-mail)
City of Renton, 1055 Grady Way Renton, WA 98057
SAMPLE INFORMATION
Sample collected by (name): Casey Grant
Specific location where sample collected: 1012 SW 4th Pl Special instructions or comments: New hydrant C25001798
Type of Sample (select only one type of sample from types 1 through 5 below)
1. Routine Distribution Sample (A/P)
Chlorinated:Yes No
Chlorine Residual:
2. Repeat Samples (A/P)
(from distribution system after unsat. routine)
Unsatisfactory routine lab number:
Unsatisfactory routine collect date:
Chlorinated:Yes No
Chlorine Residual:
3. Ground Water Rule Source Sample
Triggered (A/P)
Assessment (A/P)
4. Surface or GWI Raw Water Sample (Enumeration)
E. Coli Fecal Filtered: Yes No
5. Sample collected for Information Only:
LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY
Unsatisfactory Satisfactory
Date/Time Received: 6/11/2025 2:27:00PM
Receipt Temp (C): 26.5 C
Date Reported: 06/13/2025
DOH Lab- Sample# 0660-M25F0121-02
Lab Reference Number: M25F0121-02
Method Code: SM 9223 B (Presence/Absence), SM 9223 B
(Presence/Absence), ,
Lab Use Only:
Total:
Free:
Total:
Free:
|__|
Bacterial Density Results:Total Coliform: Absent/100mL E. coli: Absent/100mL
Fecal Coliform: NA/100mL HPC: NA/1mL
Total Coliform ABSENT and