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HomeMy WebLinkAbout19-M002982.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: 05/30/2019 Collected AM Month Day Year 11:00 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: FINEY SHORT PLAT U-16005573 Contact Person: ABDOUL GAFOUR Day Phone: 425 430 7210 Cell Phone: 425 282 2373 Eve. Phone: FAX: Send results to: (Print full name, address and zip code) CITY OF RENTON ABDOUL GAFOUR 1055 S GRADY WAY RENTON, WA, 98057 SAMPLE INFORMATION Sample collected by (name): BRAD STOCCO Specific location where sample collected: HYDRANT Project Name or Comments: W-3915 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: 5/30/2019 Date Analyzed: 5/30/2019, 13:45 Date Reported: 5/31/19 066-02982 Sample Number (DOH number plus five digits) Lab Use Only: DOH Form #331-319 (revised 02/16) Finley Short Plat - W 3915 2525 Aberdeen Ave NE U16005573- WTR27-03915 E-MAILED ON 6/5/19 TO: Brad Stocco, Gregg Seegmiller, Emina, Andrew, Justin Johnson