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BEGINNING
OF FILE
JUN-28-2002 FRI 04:23 PM KING CO -_ FAX NO. 2309E P. 02
—, Laueks Testing Laboratoriss,Inc. Laucks Testing L.aborstorles,Inc.
040 S.HArttay Sean',.WA 9Bt OS I l 940 S.Ha•nay Seam,WA 981 CS
WATER BACTERIOLOGICAL Ali'ILLYSIS WATER BACTERIOLOGICAL ANALYSIS
SAMPLE COII SCION:READ INSTRUCTIONS ON BACK OF GOLDENROD COPY - SAMPLE COLLECTION:READ INSTRUCTIONS ON BACK O!GOLDENROD COPY
II itMnN:iMEH Ara not AtNerrd,sample WW be miectod. If k *uCt'nln—ttol 10"wvd,aalllpM will be folec4d•
UATE COLIItTEO �1 ECOl1 cm LOLfNTy NgME OnrE ClX1ECTEJ rIMEy COUNTY NAME
MOMTx OAr yMR } `'xL 1/ / _(o K
G? 27 �Z AI+ (]PM 1 U a W ' AM ❑FM
-TyYF OF SYSTEM IFWdµI008YEM,COMPLET[: ._--- ' PE OF SY6fEM NPUBLIC 4YST[M.ODIaP:k1F
LYtRn SIC RPuuK ''/
I.I OdAVB>LIAL � GNJUP C� l I
r,,.rrtlwil...Q t. �' 1 56 A B ❑INOVtOlLt1 LD.NO. A °RDA'
_ I,.�i.wr I.�IY..I
NAtdI OF 6\'STLM NAMEOFSYSTEM rf Crr 2t✓►.�To��
CIT�' cw ��L`1TQF�j CI
SVTCAN:IgCAIIOH mFR[DNARE CdUYCTED TELEPHONE If0 SPEORL LOLA^,1N WgN`gI�SQ'y`LE'CO�(C�`fF�—Et CPHOhE NO.
�-� �Y.DIzA►.cT °"° - I ZZ '�y.�_4�?q•!$�Z
_ _ _L %.ow- o,fYSTEM I.—i— LVBIIN[:[ I
SAArtIF LYA LEti['D D\`Blaym�el,I SYSTEM 01yNFjCVM'OR';-Mr>�TN SAMP COLLECTED By.INMn.I ISYSTE.NI'L yM1piE;pynu)
SOURCE TYPE GROUND WATER UNDER SURFAC mRUENCE SOURCETI'1'E GROUND WA ER --
''UAFA(• HOER SURF [INFLUE�N,/CE
L7 E rJ W�FF,IFLO PAING ❑P TEATif EDw�o,C B UTION ❑SURFACE ❑WELL FI ❑SPRING U I"KrIE a w roTamNTpN
_ 1NTfq,¢ wCTHER WELL FIELD INTENTIE wOTHEq
RF �r 10 NA
nw,Addau n0 LO Goan REPORT Tq�Pfrwt Une.Adomae a ZIP
p°m... �"•ITQA P- l ITf AVM '(/
_fUSS.C��AvY�LRY� � �1�L
WM.. wY:4W rS/ 1 W
r14Y TN'GU4TAWPlC(rlrocA ony enQ'n this a w"') TYPE OF SAMPI F(cNack only on Arthmcolumn)
L�OFLXlL �-1 Cmw�narotllRa�tloN.—Total F ❑ROUONC
DW IN:WHIR LI�J-t — 'eel DAWKINGWATEN v,,, r)
OwL a.xnaPl L J I,nurotl flwax InoanAN ❑FA~
rJ Un",Iw a,ONb
['1 u:PrAt sAfrt E Q aalw w co,---.--- _
/A R�'wNn 1 i vm n l np¢e tnb a„ _____ I L;REPEAT SAMPLE
"1 ) Pnr�euo ronNm.Pgwnca
lA' flda I--r--t
ll� [iAVI F:OUNI•C LW1 rH Smv vl F ❑Tcty Laldon- I ❑RAW SOURCE'NATER Safea r L3� I I I [)TeW 0*10 ,
yM NEW OINE11 ."way)CIMIH wRCfnI1P3 --, - Fecal Catu.•n I NEW CONSIRUCTION ot .iPAM L1.-! r'�e
t�oTFILTi I"Ine�ro
RF.MAHILS REMAIR f ONL\1 DRINKING WATER RESULTS RAS USE ONLYI DRINA"AQ WATER RESULTS
L�UNOA7 L�FACTUIfy f-Wdo!", ,! 't.... SATISFALTDAy ❑UNSArISFACTOPY,Dolib,mf pewit ATISFACTOM,
xam!s aDeant
RFFLAr F.C,* rfanl aaDw1111
fJMI'1 r5 p ❑E �� REPEAT ❑E.CdIMWrt ❑F.Ca,anmN
RPoUWIU []Etta)PN•faM raWlatlsane REOUIRED ❑
.`--.._ ❑ Face D,rrrlt []Fau'rMnN
OTHER LAeORATORT RESULTS .... OTHER UmO1NT0Fvy- WLTH _--
TOTALCrK!lCaGf—nOD ml E.COLI_nOO ML TOTAL COLFORM—n DQ IT, ECDII _M00 ML
rf CALCRIIf(VW__nOltnd PLATECOLINT—l" FECAL COUFORM_,nCO In. PLATE COuH!_,,Ina
ANOTI SCR SAV LL* RED ANO-HEI SAMPLEREUulrrU .•_----
SAMPI.PNOTIES'IEO BECAILSC; TEST UNSUrASLE BECAUSE'. SAMPLE NOT TESTED BECAUSE TEST UNSUITABLEBECAUSE-
Stn%*fa,on; ❑COWLNnt OMAN, ^`1$a!,"Loa ole ❑tonArmfyrwR,
vJ^vID oNlinw.v ❑TNTC JWro%caNrw
I ^� J TNTC 1-�4nouplulA two, ❑Tm D'J Cow. ❑lnrompme loin, T.'b"".U.
•- ----- - - ❑E.I:ae:Oaaa ❑--..--- L-iEs.an nasnc
BEF NEIIFREr vDF Of DARIN COPY FOR ERPLANATION OF RESULTS SEE REVERSE SIDE OF GREEN COW FOR rXPLANATION Of RESULTS
LW MD.V M't1al DATE.I WE PCCCACJ ALCCN�D Il. Ua N0.ITNQM DATE.VUk A[CQi,i U i R�[xiM'C or
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1 IW[Nc1W'rtcnp 1_—. . IAMAK,Mrr /1G CAVE AQrgrtna
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