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HomeMy WebLinkAboutDecember 2010 • ■IJN N t 3 U T A SECTION OF DRINKING WATER PROTECTION See Instructions on Reverse Side to Complete Form • MDH PWS ID# Month of Fluoridation Monthly Report(Single Well) See p /0 , .., o l kp , Name of Facility r Street 0. ol?A, 14168 Oak Park Blvd. N. City Operator Name(Please Print) Zip Code Oak Park Heights 3" PF K-�e9 LL 06'66" 55082 Signat r� �����e1�� Titl� q K/c7 4 / ae,gt4 4 l Phone# i/// !y�,' Phone 651-439-4439# Fluoride Chemical Used _ -1i Raw Water Fluoride Concentration Water Source.2Y70 Y70 0. 30 mg/I IV - -p Jj 1 Meter P1u00 pgg ) Amount of Solution ion Fluoridation Analysis sis Date (R0e0a0 dign l.) oC d (gals.) Tested Fluoride Sam lin Pgint Concentration on Diistribution (ma/l) System Day# 1 2 3 4 5 1 635 167 0277 /• 5 /• / y 1.x4 C 2 237&8 1 (9/ 1. 0 1 . 05 in 3 40 q 058 9a a,a /, o r 14441_S•�a` a _ 4 y33 02 tg 7q - 1 .5 /.t;-5- . PA1- G' u/I-tt 5 & yyg8 ) o 0 lea 1• /`d 5. A . Dew 6 Co' to y I S Go /• 0 /, 0 5 �j .1.o4-. 7 63, q970 ,2 lc, 1. 5 1I $ 777 8 ,J J/ cc' 1) 2. L% /,c 2 / 4- j; ML.._,,v` 9 (053y6 / / / /• 0 l•/3 G 10 656ati 0178 /. 5 /. 01 t8 11 ‘<---.s'-t_,/„:6:- :.`f' _ _, / C., / /7 25,,A/✓7 Y/c/en 4143.7 12 7‘'' C.-%94/ t /" n / . p / iT7 /4//-/,,,t '-46 13 1, 6 ) 7 / :' 2. /l o / 3-? 7)/4- 1:(--:ASi--- 14 15 /V C/�j7 ?Ci ,9y ii�jp / Ci (7�'-UQ 'c:)c-`Z 16 ( 6 T� -/ / / & l /�I � _ it 0 / I. 17 62 716 (6 02'77 /,-s" _ /. /4l l6 18 co 7 L 025 Co Ito _ x. 3) f zli, 6- ot•- 19 G 7 33 a o R 7. o ot97• -pi.R4L.,LeUd_ 20 (0 7?)a 7 1 9 y • A o 1.3 5 04-4/1-e_ PaAle_ 21 (o Qg I 1 I a co`f /• 5" /.0 c 7"/1 �, �,��.,4tre...�?u nt_ 22 (0 UQ 1�.�7Q /�� / lD r 1.V /./3 C.? �`t_. c 23 (o v 1 1 1 a. /. 0 /• /a. site-omC_e)u.c&I.k). 24 ( 53,7 4 / z 5: 6k 7. 0 J . 01 ,O.ril. Shc'p 25 (9 ,1 R 2.4 17 b • S /- /�0 CI �� /41( 26 ( (9 11 / Y 0 p !•�0/ / a 5- C ud/4 Pc-i 27 b 1 g 2 s 1 . J 1. 36, � �'�'1�".`-�i•A.. ._ 28 �G I lg Y 5 Z.4 Q1 _ 1. 0 /. 10 s - 29 ( I V 9q o2 S q /5 /. / o s! 30 70 o79 / 8 5 /. /9 7 s�� - 31 / 0 3 V O 3 09 - J a. o A / 13 ;opy to be sent back each month to: Minnesota Department of Health,Community Water Supply Unit,P.O.Box 64975,St.Paul,Minnesota 55164-0975 E-00818-02-IC 140-0013 FI-single Rev.10/20C (o ) 7��r ©oo [3/:w3r3IZ7 11 SECTION OF DRINKING WATER PROTECTION ,�}� IVI�fl Fluoridation Monthly Report(Single Well) I5 c�, OO O ` /V.Le.., a 010 Name of Fa-t ty s I Street a,ite7)471.1cOt liaUel, 14168 Oak Park Blvd.N. City Operator Name(plea..PA ) Zip Code 11 Oak Park Heights E'FF" AEG G OG& 55082 kignatureG)I ,�,� /�' P�'� s 1-439-4439 >' orls caf Used Raw water Fluoride Water source 7 y9•a 45. 17 ' c2 r e anon I of Solon Fluoridation Analysis Date i ,,' 9m) 1 .) ' t ,r gal!:. a.:. Day# 1 - 2 3 4 5 i g8356. 18 I /. 0 1. 14 /3� ziak PaAtk 2 8-5667 311 1. 5 1. 05 vt../.114.4, .�- 3 8 $'611 aa`t i. o 1 ,01 5 ,1 , 8a 174.. 9181 i, 5 /.aS eV.6- 4 5 4i9L1S7 - 3Is' /•5 J•/`6 .5r A.. Idzo-t` 6 13'7688. as i 1,0 I.0$ _ - s 89108 ,a2.0 1. 0 1 . 18 s ?046•41 ,2<o3 /. O 1. 13 G. • . ' ,' 10 ` 06,497 403 - hp /.01 z8 _ 11 go 96 g�9'7' /0 //1 5'.',,11.�,+� ' / "'"` 12 // ?4- Q 7© /0 9- . f .414 /-cc�f. sie'+e' 13 Pe 4;4/6 /7 I0 x, 33 84 �Ar u 11l� 75 451 /,a 1, II 4 . e -, C . 9/,5'7k' ,3 - A o /. 69 1"4.--- . (..,,Qr 16 %Asa08 330 /. 5 /.01 T Pf d i7 IA 9 9 1 X)3 i.0 /, I q 18 1027/ 7 .011(0 I. 0 /.3/ Pl.). 6-, , , - 19 ` x910 1 '73 /.0 , o•' 17 ll ' / , 23 93443 313 1'5 1. 35 64412k. ,' 21 ¶3 Li3 0 0207 J.d 110 9 t-P" 22 e1373'1 F 30K -/,5 - /• /3 Cris-9i- f 23 73/4,0 Azl6 - /. 0 /r //2 St412004ahAVUeaAle41 24 Cf t ifC, Z.LL 10 O7 -w- 544- Z, 5 � U l 26 1 to s' c6 Z 1. 0 /. d s' / frk 27 (4 q Vi 43 1. 0 1• 3C &e& /C4e._ _ , 28 , 5 23 . 3 - 29 /5 `i31 I ' a 1. 0 /. / 0 54. 7,,j 33 '7575' 343r 1. 5 1 , 19 7 S ,' �( 31 1.5-15/ j i 'r /, 0 /r a 6 :opy to be sent back each month to: Minnesota Department of Health,Community Water Supply Unit,P.O.Box 64975,St.Paul,Minnesota 55164.0975 E-06818.02 bell 1�W-0o13 FRsingte Rev10/LOC /aki g ,K 7`5`.15\ 000