HomeMy WebLinkAbout4 satisfactory results- W-4162 Central Island Short Plat 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:
04/22/2021 Collected � AM
Month Day Year 10:20 � 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: CENTRAL ISLAND W416201
Contact Person: ABDOUL GAFOUR/BRAD STOCCO
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 WATER UTILITY
ABDOUL GAFOUR/BRAD STOCCO
1055 S GRADY WAY
RENTON, WA, 98057
SAMPLE INFORMATION
Sample collected by (name): BRAD STOCCO
Specific location where sample collected:
SETTER C20004190
Project Name or Comments:
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: 4/22/2021
Date Analyzed: 4/22/2021, 14:15 Date Reported: 4/23/21
066-02311
Sample Number (DOH number plus five digits)
Lab Use Only:
DOH Form #331-319 (revised 02/16)
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:
04/22/2021 Collected � AM
Month Day Year 10:07 � 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: CENTRAL ISLAND W416201
Contact Person: ABDOUL GAFOUR/BRAD STOCCO
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/BRAD STOCCO
1055 S GRADY WAY
RENTON, WA, 98057
SAMPLE INFORMATION
Sample collected by (name): BRAD STOCCO
Specific location where sample collected:
BLOWOFF C20004190
Project Name or Comments:
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: 4/22/2021
Date Analyzed: 4/22/2021, 14:15 Date Reported: 4/23/21
066-02312
Sample Number (DOH number plus five digits)
Lab Use Only:
DOH Form #331-319 (revised 02/16)
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:
04/22/2021 Collected � AM
Month Day Year 10:05 � 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: CENTRAL ISLAND W416201
Contact Person: ABDOUL GAFOUR/BRAD STOCCO
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/BRAD STOCCO
1055 S GRADY WAY
RENTON, WA, 98057
SAMPLE INFORMATION
Sample collected by (name): BRAD STOCCO
Specific location where sample collected:
SETTER C20004190
Project Name or Comments:
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: 4/22/2021
Date Analyzed: 4/22/2021, 14:15 Date Reported: 4/23/21
066-02313
Sample Number (DOH number plus five digits)
Lab Use Only:
DOH Form #331-319 (revised 02/16)
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:
04/22/2021 Collected � AM
Month Day Year 10:22 � 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: CENTRAL ISLAND W416201
Contact Person: ABDOUL GAFOUR/BRAD STOCCO
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/BRAD STOCCO
1055 S GRADY WAY
RENTON, WA, 98057
SAMPLE INFORMATION
Sample collected by (name): BRAD STOCCO
Specific location where sample collected:
BLOWOFF C20004190
Project Name or Comments:
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: 4/22/2021
Date Analyzed: 4/22/2021, 14:15 Date Reported: 4/23/21
066-02314
Sample Number (DOH number plus five digits)
Lab Use Only:
DOH Form #331-319 (revised 02/16)