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Home My WebLink AboutWTR2702762 WTR-27-2762 BEGINNING OF FILE rj \ \ \a �0 to � / AD � f� § \ } .s �y \ : 2�< : y�i } t _ I Laucks Testing Laboratories, Inc. 940 S.Harney Seattle,WA 98108 WATER BACTERIOLOGICAL ANALYSIS 1 SAMPLE COLLECTION.READ INSTRUCTIONS ON BACK OF GOLDENROD GOPV , H Inebuotl0m an not followed,sample win be rejected. DATE COLLECTED COLLrtpo COUNTY NAME 4 2 p► YEAR oo AM /JPM �f) ❑ k�,� H � TYPE OF SYSTEM IF PUBLIC SYSTEM.COMPLETE: �]PUBLIC ❑ NDIVIDUAL CITE OROI�P I.D.No. `� A e NAME OF SYSTEM t C I � Of SPECIFICLOCATONWHEAE$AIMECOU.ECTED TELEPHONENr+Q F,M1I I'1y br A <XZ DAY � G3r ?�o y4 "VENING 1 ) } SAMPLE COLLECTEDBY:Hamel SYSTEMOWNER/MCR INamel SOURCE TYPE GROUNDWATER UNDER SURFACE INFLUENCE ❑SURFACE []WELL or ❑'SPRING ❑PURCHASED Or XCOMBINATION WELL FIELD INTERTIE or OTHER SEND @EPpp�TOnm:(P u11 Noma.Address and Zip Coda) _ TE 1•Rv /G. /aOfS JIu#h C".ANY (w,� tZX�t�o. _ BRSS j TYPE OF SAMPLE(c k my one in this column) I ❑ROUTINE Cnlorinated DRINKING WATER ❑ IReedual:_Tolel_F. check inMenem ❑F,ftmed ❑Untnwed or OIrw ❑REPEAT SAMPLE r Preyroue col,tortn Presence Lm e Date RAW SOURCE WATER Source a❑$ m ❑Total CWfonn NEW CONSTRUCTION or REPAIR$ ❑Focp CoH REMAt A• G'� !_J �n h 7e C (LAB USE ONLY) DM N10 WAVER RESULVB ❑UNSATISFACTORY.CdRama preeant ❑SATISFACTORY. CNda rns meant REPEAT SAMPLES ❑E.Cdi Present ❑E.Col,ataent REQUIRED ❑Feal pweent ❑Face meant OTHER LABORATORY RESULTS TOTALCOLIFORN I mooml E.COLI „_n00 ML FECAL COLIFORIA _/100 ml PLATE COUNT_/ml ANOTHER SAMPLE REQUIRED SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE: ❑SamPb too old ❑Coneuart VmWto ❑Wnmp commne ❑TNTC ❑Ineompwo t�nn ❑TurWd culture ❑ ❑Eaceea daona SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS LAB NO P DGMSI DATE.TIME RECEIVED mawo BY DATE REPORT WpU �•/ rENs,A�e �It � -j INN S'UPPL IER COPY Loucks Testing Laboratories,Inc. 940 S.Hamay Seattle,WA 98108 WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION-READ INSTRUCTIONS ON BACK OF GOLDENROD COPY N Instructions am not followed,Sample will be miscted. DA. COLLECTED TII COLLICTED COUNTY NAME MONTH v YEAR OO 2 C m AM ❑PM k r r C • TYPE OF SYSTEM IF PUBLIC SYSTEM,COMPLETE PUBLIC e ❑INDIVIDUAL I.D.N0. CI E GROUP ..m „nPea� C� 7 1 8 s ►— t B 1 NAME Of SYSTEM — C' SRC LOrAgN RISE 10"U'C7® T No. r ae My4/A � t� I DAYELFPIgNE Ilit -LbYG + opt Sw t 3+_• Er EVENING r e a SAAWLECOLLECTEDW:Ifalnlel SYSTEM OWNEILMGR.:(Nade) ! . • + ht• wETNL)z SA 16 SOURCE TYPE C WND WATER UNDER SURFACE INFLUENCE El SURFACE ❑WELL W ❑SPRING ❑PURCHASED WTI COMBINATION WELL FIELDINTERTIE W OTHER SENQ RFfp�T TO:(PrYM GFr�I Nlift.MIMM YM r Zip Code) /D S .S ..ae V't'Y\ G/ Ai 1A,u►-� TYPE OF SAMPLEIcheck only one In aft PSAatag ❑ROUTINE DRINKING WATER ❑CNW filed(Flowdual:_Tutal F lap click VeMmant ❑Filtaretl ❑Untleste.,or Olmr_ ❑REPEAT SAMPLE -- Provious coif r Pnne a Lan N Date RAW SOURCE WATER StKeTw e Q m ❑TOW Coalorm NEW CONSTRUCTION III,REPAIRS ❑Fecal Cold,,n+ ❑OTHER(Specdy)- w REMARKS. — ILAS USE ONLY)DRINKING WATER RESULTS — • ❑UNSATISFACTORY Colitorme I,mIant ❑SATISFACTORY REPEAT ❑E Coll Praeard ❑E.Col,abeant Coldorrne aCaent SAMPLES REQUIRED ❑Facel wevelt ❑Fecal abeam _ OTHER LAaORATORT RESULTS TOTAL COLIFOPM _n 00.1 E.COLT C_1100 ML FECAL COUFORM /100 m PLATE COUNT_/ml ANOTHER SAMPLE REQUIRED SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE. ❑SanrPN too old ❑Conauent growth ❑Wrong m a'ne ❑TNTC ❑❑lnCOf^PKKe 1onti ❑Turbid cufm ❑Eaceee deem SEE REVERSE SIDE Of GREEN COPY FOR EXPLANATION r RESULTS UB NO IT MGITS) DATE.TIME RECE70" RECEIVED BY 0'— MTE REPORTED tAAORA �� N oa taaN FaY.+B WATER SUPPLIER COPY Laucks Testing Laboratories, Inc. 940 S.Harney Seattle.WA 98108 WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION:READ INSTRUCTIONS ON BACK OF GOLDENROD COPY M(R°hvetbns ars not followed,""Will WIN be rejected, DATE COLLECTED TY.IE COLLF�(,gD COUNTY NAME MONTH ILI,A, vFAR �L_ Oc� Z IO OCWj AM ❑PM k " TYPE OF SYSTEM IF PUBLIC SYSTEM.COMPLETE: IS PUBLIC I ElIN�^INDIVIDUALUALee.rca (�� B I,Q.�, ® CIRS,LE GROUP n NAME OF 3Y////jjjjSS$STTTT,,EEEEM SPECIFIC LOCATION WHERE SAMPLE COLLECTED TELEPHONENO. / g �a..I n ru DAY 3F^ ?b`r 7,4- EVENING' SAMPLE COLLECTED BY(Name) SYSTEM OWNE (Name) SOURCE TYPE 91GU6 WATER UNDER SURFACE INFLUENCE ❑SURFACE ❑WELL or ❑SPRING ❑PURCHASED a®COM&NATION WELL FIELD INTERTIE wOTHER SEND){ ' Tp.(Pmt Fuy Name.AtlMeae anE 2W COW) I � I w rpk at r[3ROUTINE MPLE(check only one in this column! KING WATER ❑CAl-n OI d(RlISKI":_Total Fee) k treatment ❑FIHsretl ��.. ❑REPEAT SAMPLE ❑Un::RE L MO PRnW6 Cdlfg-PrpeenC. Lab Y_ n�E`[ev�_''� q`(I'E'— tj Data ___—r`v * P RENTON ❑RAW SOURCE WATER Sources $ 10 S T w Cdlb NEW CONSTRUC7/q�NN�w REPAIRS ❑Fecal Conform rr��auR�I�COTHER/(Swity).fC--oLL�L�• fivin (LAB USE ONLY)DRINKING WATER RESULTS ❑UNSATISFACTORY,CUlforme present ['j SATISFACTORY. REPEAT E.Cap esent Colnonna abnnt SAMPLES Pr LJ E.COI,absent REWIRED ❑Facel present ❑Fecal absent n OTHER LABORATORY RESULTS TOTAL COLIFORM r_i_/100 ml E.COLT&_/100 ML FECAL COLIFORM_- /100 mI PLATE COUNT_ /m) ANOTHER SAMPLE REQUIRED SAMPLE NOT TESTED BECAUSE: TEST UNSUITABLE BECAUSE ❑Semple too Od Confluent growth ❑Wrong coma' e ❑TNTC ❑Incwapkte form ❑Tumld Culture ❑ ---_.._— ❑Ekcua Oebne SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS LAB W.p Do DATE.TIME RECEIVED mawo eY GATE tAagwToRY �. o ralmm� WATER SUPPLIER COPY I 02/17/00 THU 16:34 FAI 767 5063 LAUC%S TESTING �DQJ 940 S.Harnay SeaRla.WA S6100 WATER BACTERIOLOGICAL ANALYSIS SAMPLE COLLECTION:READ INSTRUCTIONS ON WX OF GOLDENROD COPY R insbwVI n3 am not followed.Sample will be mlocted. GATE COLLECTED TIME COu.E_CT,�p COUNTY NAME rONnI wr KAa —IKI-- OV Z /I(o /00 �AM pPM I k I rD TYPE OF SYSTEM IF PUBLIC SYSTEM.COMPLETE: �CIINDIVIDUK I.D.No. 7 I S / C lryE BROW I wr u.nravl� b NAME OF SYISTEM 6A //- CrJ� C Ae�f VECMCLOCA WNEPkS IECOU.lCTEO TELERgNE NO. 11�w F',.c� N-7� DAY 3 -dLf�6 I E1rENINfL SNARE COLLECTED BY:(Nwrlc SYSTEM OWNE N M,w erHEua /r t i SOURCE TYPE GROUNC WATER UNDER SURF INFLUENCE I pSURFACE pWELL or p SPRWO p PURCNASEO or[iCCMINNATON i WELL FIELD INTERM >OTHER N SENDR§P01jf T0: Nn FErb'G /n o� C� --LBO_ . I TYPEOFSAMPLE(CMCk PAMOne�WSCWuanl ❑ DRR RI E WATER p Cnlonnow(WCAull _TOW FnN tlwk~MW ❑Flhww ❑Ilm'WIAd or OIMr p F-PEAT SAMPLE PrAvbuA roLterin pnMCA ltl p PAW SOURCE WATER S.0 *A••�, Cl Tug CWMn NEw CONSTRUCTION or REPAIRS ❑I"Cw%b CT4EA ISP M oils ze Cy GAS USE ONLY'1 DRWRANO WATER RESULTS p UNSATISFACTORY,Colifpma DnAant ❑$ArSFACTORY CalkolmO ae..n< REPEAT p E.Ce6 onaAnt E.Coo WLnIt SAMPLES FaCY prPAAnt p FKa APAAIIt REQUIRED ❑ OTNER LABORATORY RESULTS TOTAL COUFORM 1100 mI E.COU A—/I OD ML FECAL COUFORM It DO ml PLATE COUNT_/Ro ANOTNEA SAMPLE REQUIRED SAMPLE NOT TESTED BECAUSE: TEST VNSI IITAkE BECAUSE' ❑Sa^Io*Im O:d ❑C.flu 7 p"W'ww pTNTC ❑v,o Pew rym ❑Twbw Carton ❑ ❑EArRAA GPM SEE REVERSE SIDE OF GREEN COPY FOR EXPLANATION OF RESULTS LY ND IT0tn3I DATE,*IME RMVAT, RECET4D BY 16�tPL{g } �� oo l '. 3o v',!4 oArt RE o Low"AT0 . OR CENTER COPY _