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HomeMy WebLinkAbout17-M007442.pdf 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: 11/10/2017 Collected AM Month Day Year 11:05 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 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 Data Delivery: MAIL EMAIL: SAMPLE INFORMATION Sample collected by (name): BRAD STOCCO Specific location where sample collected: SUNSET COURT APTS E STAND PIPE Special Instructions or Comments: W-394401 Type of Sample (must check only one box of #1 through #4 listed 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. Raw Water Source Sample E. coli - GWR source sample Fecal - Surface, GWI, some springs Other |__S__|_____|_____| Public Systems must provide Source Number from (WFI) Unsatisfactory routine lab number: ____ ____ ____ ____ ____ ____ ____ ____ Unsatisfactory routine collect date: ________/________/________ Chlorinated: Yes_______ No_______ Chlorine Resid: Total_______ Free_______ 4. 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 Fecal coliform present Fecal coliform 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 < 1 /100 ml. Fecal Coliform /100 ml. Method Code: SM 9222B Date Received: 11/10/2017 Date Analyzed: 11/10/2017, 15:00 Date Reported: 11/11/17 06607442 Sample Number (DOH number plus five digits) Lab Use Only: DOH Form #331-319 (revised 02/16)