HomeMy WebLinkAboutRIVER VIEW ESTATES BLK 6 LT 3
CHEMICAL & .,EOLOGICAL LABORATC
P.O. BOX 4-1276 TELEPHONE (907)-279-4014
Anchorage, Alaska 99509 274-3364
Drinking V ater Analysis Report for Total Coliform Bacteria
TO BE COMPLETED BY WATER SUPPLIER
~.~ ! ~ I.D. NO.
Public Water System ~
Mailing Address '
City I State Zip Coda
bio. Day Year
SAMPLE TYPE:
[] Routine
[] Check Sample (for routine sar
)cASh lab rBf. no.
[~:~pecial Purpose
SAMPLE , ~- Time ~ Collected
NO. LOCATION Collected ~y
3 I
pie
) [] Treated Water
[] Untreated Water
.IES OF ALASKA, INC.
ANCHORAGE INDUSTRIAL CENTEH
5633 B Street
TO BE COMPLETED BY LABORATORY
Analysis shows this Water SAMPLE to be:
J~'~atisfactory
[] 0nsatisfactory
[] Sample too long in transit; sample should
not be over 48 hours old at examination
to indicate reliable results. Please send
.,new sample.
D!te Received ~ - ~ ~-~0
Time Received ~/? ?~L-~-~
A!alytical Method:
[] Fermentation Tube
I~Membrane FiLter
Lab Ref. No. Result* A.nalyst
I F-r-I
READ INSTRUCTIONS
BEFORE
COLLECTING SAMPLE
06-1220 (b)
BACTERIOLOGICAL WATER ANALYSIS RECORD
Date C oil ~ct 6cJ
I No.
Collform/1OOrnl