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: .STATE OF WASHINGTON <br /> ' � �EPARTMENT OF HEALTH <br /> WATER BACTERIO�OGICAL ANALYSIS <br /> E-.MPLE CULLECTION:READ INSiRUCTIONS ON BACK OF GOiDEfJRUD COPY <br /> II in�imclion�nro not lollow�tl,sempla will W r1������ <br /> �AiELOLIECTED TiMECOLLECTEO COVI+TYNAAfE <br /> Y.9ry1H DAY YEAR � . ��_ <br /> � z. I(�S l� AM �^ PM ?Jv�'�,�^��1 I tEI <br /> ivPE0F5YSTEN� IFPII&ICSYSTEM,COMPLETE <br /> �� PUBUC - � ( �� p�y��RWP <br /> '�: ir;oiv,ouu ID-No- � 4-1 � �� 'J � ( A� 8 <br /> ��.M.�,,,,,. �.� �� <br /> NAME OF 5Y'iT6M . <br /> d "�.�i �- V: °F_f7 <br /> SPECIFICLOCAiIONWHEREGMPIECOLLECIED TELEPHONENO. <br /> oar IJ:� ' ;'7 ?YC-', �. <br /> 1� <br /> . . . .. � ���,�.�,-r .-`,' -'7/� -- ' <br /> eveniuc I I <br /> SAMPLECOLLEC7ED9Y.(tlame� SvSiEMOWNEWIAGR �rvamel 'I <br /> � <br /> _w. �i,�.c !.tF'e'�;r_ ( V_� F -., �. <br /> SOUflCE7YPE ❑ GRWN�'NATERUNDERSURGFCEIriFWENCE � <br /> n SIIAFACE ❑ N�LLFIEID ❑ SPqINC L NTERTEEDa ❑ G�OTHEpt�G�/ , <br /> SEkO REPfiRI T0��Prmi FWI Name.Ana�ess ana Z�0 CoOel <br /> I[ ��IY i r(�„ _ _—_' . <br /> I� .(��'•1 1[ "1'` ��: °l�l ll:'�� �MLvOttl� <br /> r ,1i . <br /> nvE oP sAMPIE(cnr,k mly one in m�s:nlumn) <br /> � <br /> [l, ROViV�E f� Cn!ormaieaiResrLai ___ __Tu�ai._,��eel <br /> DR:NaYGWATER ❑ FNe�ea , <br /> cnaUVeatmem _� .�' UnueateGwONe�_"_'___.____ ' <br /> ' REPEAiSardPLE '� <br /> Prev.00s coi�o�m preserce la0� _ ' <br /> �ate Ca!ec¢4 .. ._—__ . <br /> ?� qAW SOURCE 14ATEP Somce� � m LJ Tciai Goi���crm ' <br /> (�1"KEIYCONSTBUCilOYoiFEPAiRS �1 �eca.Calan , <br /> [I OiMEfl�Spec:ly) � <br /> �� <br /> RB.IANHB ��� � � t��`�+ 1� ,� ' <br /> 1 1 I i_'' �_V�e_1�] �_f�— ' " -- _ <br /> _ �� ) ��. �� �/ � �— <br /> _ . . Lr���:L1.—��.�'� `�-� <br /> (LAB USE ONLY)ORINKING WATEB RESULTS____ � <br /> , UNSATISFACTORV.COIJormsp�esem i . SATISFACTORV <br /> f,o�Jorns aesent <br /> AEPEAT E.Colipresenl . � E.Col�abseni <br /> -Ai.IPlES ' � -' i <br /> R"eOUiHE� �_I Fecalpresent ' � Fecala�senl <br /> OTHERLABJRATORYRESULTS ', <br /> rera�cbuFca�a _ naa� e mu ----;iow,a <br /> FECALLOUFOFh1 �i00r„i PLAtECOUNT__ ._ �m� � <br /> ANOiHEF SatIPLE REO��RE� <br /> SAMPlEN01iE5TE0BECAuSE 7ES7UNSUI7ABLEBEChU;E � <br /> 'u Sdmplc loo old ❑ Canlloe�l g'orvin <br /> ;__ Wiony<onla���er ;J TNTC <br /> [,' Incomp'�Ia�o�m Tw��dculW�e <br /> � .J E.ce;s tleons <br /> SEE REVFRSE SIL°OF GRE'cN CCPY FOR EXFLANATION G�RESULTS <br /> :A6'�OpDIGi15: � ��1Eii!!eNECifJF� ����6Y <br /> i <br /> � - -' 1 <br /> i �� �•,1�; � ;;`� r' � �'I ��;� �, , �: ! ; �.;�;;� � <br /> � �_�. ri = �. ' <br /> 'i qEPCf.iF:� ` � � �A�OBaiOur 1 � • <br /> � CITY OF EVERET� <br /> ENVIRONM[MAL I.A6IFATORY <br /> 7200CEDAR STREET <br /> � � �� � FVEFETTWA9B207 <br /> V4'ATER SUPPLItR COPY <br />