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013189464_w&s
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Last modified
8/4/2020 10:38:29 AM
Creation date
12/17/2012 11:49:35 AM
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HealthDept-Rural
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013189464000
Box #
260
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: <br />l f @ iF CObiff5iF14H OEPARWNT LABORATORY - BACTER I OLOG I CAL 10310039 <br />21 CEDAR, DR M12 <br />a� A. . Z- A t A �., FOO1072 a EX0004794 <br />d SPACE BE wrlFN <br />< TIME COLLECTED CITY OR <br />Q_ DATE COLLECTED O L COUNTY Lm y QQ�i.e ate. 4 <br />J <br />p SUPPLY OWNED BY c,,�C[► <br />x <br />~ LOCATION <br />V) PREVIOUS SAMPLE TNTC,CONFLUENT GROWTH,OR TURBID Y S <br />F SAMPLING POINT yL,�" ty, _t" h� <br />z IS SUPPLY CHLORINATED? _ YES _ NO <br />v CHLORINE TEST MADE AT SAMPLING POINT? _ YES ;-`O' <br />0 RES.CL. PPM COLLECTED BY Cr - <br />m REPORT RESULTS TO: <br />ROUTINE <br />um <br />DATE REPORTED ILI uI� II IIII�I Ili��l��lll�ll�ll�lll�lllll �,M a <br />n COLIFORM ABSENT <br />C D MEMBRANE FILTER COLIFORM PRESENT <br />w FECAL COLIFORM ABSENT <br />� n <br />y D PRESENCE- ABSENCE FECAL COLIFORM PRESENT <br />w <br />0 <br />HETEROTROPHIC PLATE COUNT /100 ml <br />N <br />W n <br />D FECAL MEMBRANE FILTER FECAL COLIFORMS /100 ml <br />= <br />2- 11LUTION MPN � � - � COLIFORMS /100 ml <br />Z v • <br />R <br />FECAL. DILUTION MPN ,� 2 FECAL COLIFORMS /100 ml <br />UNSATISFACTORY (PLEASE RESAMPLE): �' <br />
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