NYC-WTC_000195739

LG8T8L900 OOTONT? ALIO NYC 9/11 Public Portal Document 13:57 No.002 P.02 Feb 05°02 TEL: NEW YORK CITY DEPARTMENT OF HEALTH - BUREAU OF PUBLIC HEALTH ENGINEERING 2 LAFAYETTE STREET, 11TH FL, NEW YORK, N.Y. 10007 TEL: (212) 676-1520 Fax: (212) 676-1597 , REQUEST FOR BACTERIOLOGICAL ANALYSIS SAMPLING FOR 3 PUBLIC WATER SUPPLY 1 BOTTLED WATER =) BEACH WATER . 1 POOL WATER ‘WELL WATER Sf WASTE WATER (2 OTHER CHAIN-OF-CUSTODY RECORD Name of Sampling Levatian (c € FT )bncation Address Ua) TC Sampling Source: Date/Tyne Sample Taken: Sample (1. #. _ Pond 1/28/03 Gkoune z2EKy boroueh. 2 BOUND ZERO i to M45 Pablic Health Sanitarian: i): Water Run No: S/ A SAMPLE PREPARATION Stored @4°C: i¥es DNo Tap: DFlamed “3 Nut Flamed Man Ancée siesu 661 Complaint (CC#): aj la FIELD TESTING: Chlorine Residual (ppm): — pH: — Sample Temp (°C?F): Field Comments/Kemarks: Received by Bureau of Labs [455 First Avenue. NY. NY 10016 Tel: (212) 447-851] | Ww’ Ye: Time: Sample Temp (°C): Name. g Signature: 1 28\ck \. Cats So s® casts -ToOw SAMPLING ANALYSES LAB NO: TAQ, MULTIPLE. TUBE DILUTIONS (MPN) MEMBRANE FILTER COUNT (MF) 1ML 0.) ML 0.5) ML 0.001 ML LT BG EC LT BG EC Ae BG EC LT BG EC | QUANTITY TOTAL FECAL : FILTERED COLIFORM | COLIFORM OTHER 244 $8 | 24] 4A | 24 | 241 48 | 24 { 48 | 24 | 24 | AR f 24 | 48 | 24:1 24 4 48 | 26 | $8} 24 . 1}OL +) QOlO] CO] O O;O ‘Ol Ke) 2O}] HA] dla} Alo OlO folke sO] FIOTOIG! QO O;,o O10 sJOlFIOlOlo ;~ OO, 8] © oO; oO slOlA Lai S/O] CO O1 oO Ol oO O19 Ola O19 QO] 0 Coliform Coun (MPN pr ME/I Fecal ColHorm Count MPN)or /100m)) Standard Plate Count ( /ml) as <29 Date /Thaye Analyzed: Date/Time Reported: Bacterlo s): Lab Comments/Remarks: Wala - 2. echo FEB ~ 1 2002 ' . ateey eR ee _ PHE 102 (295) NYC-WTC_000195739