Loading...
HomeMy WebLinkAbout23-M005654 AmTest Laboratories 13600 NE 126th PL STE C, Kirkland, WA 98034 425-885-1664 www.amtestlab.com COLIFORM BACTERIA ANALYSIS Date Sample Collected Time Sample County: 10/23/2023 Collected � AM Month Day Year 12:07 � PM KING Type of Water System (check only one box) � Group A Public� Group B Public � Private Household� Other: __________________ Group A and Group B Systems Provide from Water Facilities Inventory (WFI): ID# 71850L System Name: CITY OF RENTON: CANOPY PROJ Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: Eve. Phone:FAX: Send results to: (Print full name, address and zip code) CITY OF RENTON WATER UTILITY ABDOUL GAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected by (name): KIP BRAATEN Specific location where sample collected: 4" B/O @TIE-IN (1) Project Name or Comments: CANOPY Type of Sample (select only one type of sample from types 1 through 5 below) 1. � Routine Distribution Sample Chlorinated: � Yes � No Chlorine Residual: Total____ Free____ 2. Repeat Sample (after unsat. routine) � Distribution System � Source Groundwater Rule (GWR) (Population of 1,000 or less) 3. Ground Water Rule Source Sample |__S__|_____|_____| � Triggered (A/P) � Assessment (A/P) Unsatisfactory routine lab number: ____ ____ ____ ____ ____ ____ ____ ____Unsatisfactory routine collect date: ________/________/________Chlorinated: Yes_______ No_______Chlorine Resid: Total______ Free_______ 4. Surface or GWI Raw Water Sample (Enumeration) � E. coli � Fecal Filtered Yes___ No___ |__S__|_____|_____| 5. Sample Collected for Information Only � Construction � Repairs � Private Residence � Other LAB USE ONLY DRINKING WATER RESULTS LAB USE ONLY � Unsatisfactory Total Coliform Present and Satisfactory � E. coli present � E. coli absent Replacement Sample Required Sample not tested because � Sample too old (>30 hours) � Improper Container � ____________________________ Test unsuitable because: � TNTC � Turbid Culture � ____________________________ Bacterial Density Results: Plate Count / ml. E.coli /100 ml. Total Coliform /100 ml. Fecal Coliform /100 ml. Method Code: SM 9223B Date Received: 10/23/2023 Date Analyzed: 10/23/2023, 13:50 Date Reported: 10/24/23 066-05654 Sample Number (DOH number plus five digits) Lab Use Only: DOH Form #331-319 (revised 02/16)