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HomeMy WebLinkAbout19-M006710.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: 11/22/2019 Collected � AM Month Day Year 9:21 � 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 SAMPLE INFORMATION Sample collected by (name): PAT DECAN Specific location where sample collected: BLOW OFF DEADMAN STA 55 +00 Project Name or Comments: MONSTER ROAD 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 < 1 /100 ml. Fecal Coliform /100 ml. Method Code:SM 9222B Date Received: 11/22/2019 Date Analyzed: 11/22/2019, 14:30 Date Reported: 11/23/19 066-06710 Sample Number (DOH number plus five digits) Lab Use Only: DOH Form #331-319 (revised 02/16)