HomeMy WebLinkAboutWTR2700941 6'-WA STEEL MAIN REPLACE - N 40TH ST TO 500+ NORTIi 41
BEGINNING
OF FILE
FILE TITLE
WTS-1 WATER PP.UJECTin W-941
EaNe40thhSt. to 500± North Replace.
Permit N®br ►- -
}A. Dr hoed
Deb Eapirea:
City h4pectnt
Pro-Coe Meebut Date:
Swim)B .os y N N/A _
Premure Tmt DM 11"idecttwy Y—N
Purity TeN Dam — 5•tu(tiKtry Y__ N 4
Ay-hilt Derr:
Dreem
Sieae
BEM of Sek/Verifier! Y_- N_ Recorded
Erret/Vc...ied Y N__ Recorded w
Cot Dam Iuvenlwy/Verified y_ N__ Recorded o
F
Backtic•'mat report/Ludwitoe: y__ N__ N/A
Fire Rotectiar y__ N__ W A
Final ActePmeee BY hroec4e Y__ N__
By Utility En{inter Y_ N_
y
i
STATE OF WASHINGTON
DEPARTMENT Of HEALTH
WATER BACTERIOLOGICAL ANALYSIS
SAMP E COLLECTION READ INSTRUCTIONS ON BACK OF GOLDENROD COPY
' It In3tTUCimns are not lollowed,sample will De rsletleG.
DATE COLLECTED TIME COLLECTED COUNTY NAME
MONTH DAY YEAR - ! I
6 5 91 AM ' ❑ PM
�(TYPE OF SYSTEM PUBLIC
IF PUBLIC SYSTEM,COMPLETE.
IBI PUBLIC LD. No. tE CVes
/ �❑ INDIVIDUAL
7 1 B 5 0 L 1 D A
mn,
NAME OF SYSTEM
City of Renton MW
SPECIFIC LOCATION wNERE SAMPLE COLLECTED SVBRM o.VTAR;4GR NAME ANO hLEE1ONF ND
12 Maia.
Lake Washington Blvd. 235-264F
SAMPLE COLLECTED BY.INwml
CHAPLEZ RLLFFln1
SOURCE TYPE v
❑SURFACE ❑ WELL [I SPRING ❑ PURCHASED Ka OOer OTHER COMBINATION
ION
SEND REPORT TO Mml F I Nam.,Amn.a.M 1I0 Coal
Renton Watat slept.
3555 7B. 2nd. St.
Renton YLASNINOTCN 93056
TYPE OF SAMPLE
it.,
1. ❑ DRINKING WATER ❑ CmorlrMlaOlReeioual_io(aI__Free)
i,nii tnamant�r ❑ Flltar.E
UMrsateo OI Other
2. RAW SOURCE WATER
3, 95L NEW CONSTRUCTION Or REPAIRS
6. El OTHER ISINI
. COMPLETE IF THIS SAMPLE IS A CHECK SAMPLE
PREVIOUS LAB NO
PREVIOUS SAMPLE COLLECTION DATE
• REMARKS.
_ (W.O.Y 50600)
LABORATORY RESULTS(FOR LAB ON ONLY)
MPN COLIFORM STD PLATE COUNT SAMPLE NOT TESTED
BECAUSE
MPN DILUTION w TEST UNSUITABLE ❑ Sample Too 010
AM Ti 1. ❑ Cenlllleet G10.1h ❑ Not in Props,CortaiTBr
�kJBCOUFORM
2. ❑ TNTC ❑ IneWNR — A&sq Rear!
InsNucNon.an form 100
ry1FECAL COUFOR 3. ❑ E.nc*.e O.Dna
�'T!8MM»-IMF d_S�` ❑
I —
FER ORINKING WATER SAMPLES ONLY.THESE RESULTS ARE.
C,SATISFACTORY ❑ UNSATISFACTORY
SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS
LAB
C � ���E RECEIVED-1 L RE�IVEO By
DATE REPORTED LABORATORY 1
j lit
REMARKS
DOw AllaT lREY 121B91
IAIATCO 01 1001 11=01H'LpV