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,--------------------------------------------------------� <br /> DRINKtWG WATE�c MlCROBIAL SAiiAAPLE CO�.i.ECTIQN <br /> 8 iABORATORY REPORTING FORMAT ':�:r,t: Fno)ea�•� Pta�.Proje,t���y�H•.rH <br /> ❑Q80t 5oulhp�oin!Pl�wf�.•JadcsonvAle.FL 3Z218•904.989-0350•Fax 904.903.8354•E02674 <br /> O Q815 3W Ard�sr Rosd•Dalnenib,Fl 82EQ8•36'1.377.2948•Fax 352.386.B�i9•Eit001 � ; <br /> �10200 USA Todey Wry•Mtamer�FL 3.'1�2b•954.889.22BB•Fax B64.a89Z28'1•E6�S � � <br /> 96f0 Prinoees Paitr Ave.•Yampa,FL 39d19•813.630.9818•Fex 813.E30.t327•8846l8 ; ; <br /> �528 S.NoRh U�ae 81vd.,Sle.1Q16•ARert�oMS Splrp�,FL 3Y701•10T.937.1b94•E6S076 ' ' <br /> �----------•----------°----------------------------�----' <br /> �d��nced �b�aa.ro a r��r,a: � L ' <�` <br /> � Analysfs Qat�6 Ti71Y:�� . l� � � � �r��"�,.J <br /> �nv�fo�m��tal �a��ra�flr�e�, �n�. ����,� o��, �, o� <br /> a, <br /> or.i�,r.a.rn o.ncbd 0 ` <br /> � ..�p rnie s.mple do�s not msst a�:toYowlrp requNemsnh_ <br /> Report Number. � Sub-Contrad Lab ID: <br /> �fysls R�qu�at�d:(check all thet app(y) <br /> Total Colitortn'E.co!! OTotal ColitortNFecal ❑Enteraoocd ❑Cdiphage ❑HPC ❑Otlter. <br /> Public Watsr Sf►sbem(P'WS)Nama:�C� ��Y���L'S PWS I.D. ������� <br /> pws Aaaress:��Z �r• ti � S <br /> P1NS or wW3 a�'s hone#: '�� �� Fex# 0 . ...��, <br /> Cou�ctor.�� �J�I�1�L�L Collecoors Ptwne �+71�"Jr�CX'3' <br /> T ot Supply:(chedc only one) <br /> c.mmurrcy water syso�m ❑Non-Transient Idor�-communriy ws�r system OTtanalent Non-communily Water 3ystem <br /> Limited L�e Sys�em 06ottied Waber OPrivate WNI [7S1Mmmtag Pod OOlher. <br /> ior Sainpllnp:(check ail that aPP�Y) <br /> bfeMbutlon Ro:itine ❑DleWbudon Repeat �Raw(lriggered or assessmeCrt) ❑Raw(Mppe�ed or a�eesmer�t)ad�tlonel �Well Suwey � <br /> Cieare'noe �Repla (a�j ch°��`,�`�of eernpie being►bptaoed) OBdi Weti�r Notice ❑Other. <br /> SampN Coli�ctlton Dab: ^ !��oti Dc�r:�o�oo�s Etrsrbw ot�5.wNSae aela��o <br /> �:�< .�'°'��"�...'"� , fs: i i� b, a• :�',:a1�' <br /> � �� � y Malysl�MeM�od(s�'����1 �Z.Z.(�!� <br /> �#� (L�on�eps�Mei4ddrees) � TYPe'8 Reeldu9l � �. Nqg�- tppl E�'�,�a, 0� �� <br /> (m�lL-) Cbdifom� Coliform � s QueYllfsi'� �, <br /> �..'3 � ;�� ��.s- � �.���-.::�� t'k�3� C? . ' k "�. <br /> , <br /> ; <br /> • r <br /> ; <br /> � <br /> n+►�r�N.a n.wa�ds b.aNa+auuon rounne�+�p�at . <br /> wkpMi.'. � loline brTot�d chlor�e(drala aie). �'. Unless olherwiee not8d,aN tests are prsformed�a000rdance wlth <br /> NEUI'C sfendards,and tFie reeuhs relebe only to the samples. <br /> �q�a1 A�yrap LNtr�od: <br /> 4oiorimgt►ic ❑Othir. Wte and t►ne PW3 noUlfed by lab oT pdkive re�ulfs: <br /> �A�PMOrminO df�i� t sh wfs of bNow): Date and tlme DEPlDOH�olMlad by Isb o!paltive rewlls: <br /> oertiHsd operrta'(�'�'"!�� .7��1 Dels RepoA IowoQ: <br /> Osuperriaea oy oer�led apa�slor(# ) �.` � <br /> O emaoy.a ny a ceronen� ❑�ioyea br oEP cr oof+ lab St es: ' ,'; ':-• • -JB.-- <br /> p ncnnorfrea repreeenmtnrs o�wpppsr ar watsr TIHe: �`� <br /> [r .. '. p:c. ti'L=`..l'.1 � .:�;' • • ..t i�i:�.f_F.f•. ::'.. '4 , DEP <br /> •�` /DOH USE ONLY <br /> �'�ry� c� ���'(d�2u.� �p�s�" <br /> � .. o������� <br /> � o��.t s•�..�q�, <br /> �33� $�� o�t$.�►��«, <br /> � D86e Reviswsd bY DEP/DOH: <br /> Z�PN�t��..t�5,�Z� 335�� �,����: <br /> � <br /> �.�,9»..�a.aw�e...on.�n�m.....e..d.a�wooa....:o-or.a,.ad.ar.,�r.�..t Refinquish By: flat+a • ����Time: <br /> :.Re'fMCMrf.R.W+t N a�.�PbCf b DMlWle�t P.PM T�P.6.C�tlr(d�r��oe)• f' r��'L +� <br /> wF.a�a�ar:r�.�s�eaecaw^�;�r�an�uo�acrnc�►wa�ae ReOBfved By. DBtE:L�(�Tlme: �J C� ! <br /> � , <br /> o,.��..,...M..�, <br /> PW.�!M P1eM�A�+�YYMeth fdF RihlQ-tlD.D6U 1 <br /> onror.�or m.�.+ra��a�%w�.«n+v rowwe�w b.nsra�p�am oe��a.�..e.pw r�r.H n.w.p. <br />