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HomeMy WebLinkAboutNovember 2010 . 1 "man"'" S_ECTION OF DRINKING WATER PROTECTION PN SeD e Instructions on Reverse Side o o Complete Form M � Fluoridation Monthly Report(Single Well) /I a00 9 0 J �', O 10 R TIi Name of a fifty , Street 0.e/i, 31)40.4, tkrkekty 14168 Oak Park Blvd. N. City Operator Name(Please Print) Zip Code Oak Park Heights 5 E F F RE Z C.o&& 55082 Signs A �G1 Title Phone# /�'.a 14 ��►U- /34.444t:yJ yj. f v-7.i�lt fr k 651-439-4439 huoride Chemical Us d • , ,, Raw Water Fluoride Concentration Water Source 7 0.(2-41 �l 2 Atb a e Amou t ofpso ugon Fluoridation Anat sis Date �1�5"d'g�+.i �s(9�al�dib�}ny Tested vide Sa Analysis Pint 56 11 1 con n on on igalloon Day# 1 2 3 4 5 1 57075 / ‘ / b © /• O (1, 7 .52 cirri 2 i 3 S 7 6 Sc) 3 3© 4 S" /1 / S' ie lcr4 e....9(7- 4 s-7 / irel ► S / a5 I, / _Thea ,(p—e 5 ! 5 '79 78 I B9 /. 0 • 99 6 6 5 53 3 6 5" 4 01 2.0 1 .6/ S.A. (,cis 7 s V 5-0 12 .5 1.0 /-oz- P.W. S k o P 6 SnC•W 13(0, _ I. n 1 . 1 Z_ sL ) J Awl E-rJC 9 nrb41( 17 7 J,o , J. 0.3 ,C -vt. P -L 10 59g.311 3/3 0710 J. 1y 6 11 5. 93Zo / 3b Jo 1. 0 S 0-117f 4,41/ 12 5'15I 151 1. 0 1. 04 .S.4 . ?).,e-A•1�'_ 14 6J p Dza c3205--' /,7) /•0 rf///.41( C AIQ e 15 4,0,2 57 i et 7 /. 0 1.1 T P - 16 100353 1 lay - s 1. / a- r--4%,-e. 17 &O5`!7 / 6C0 /0 0 l,0S Cvit !°a 't- 18 60 75 c2. a 05 /. 0 _ /.ao 0/ . i' . C , 16 10 1 105 3 53 .2,0 j 0 9 -5- 4( 7j4t 20 10 / l qaZ 6 7 e5 /,oa 7-a.2Q 21 (9 / 1,157 c s I' 0 e1cl P 22 ( / COL/3 1 q6, o / 3 ' C,v�t, /'a.t tt. 23 /v t `g l 0 1 6 7 j. 0 1, 1 0 padate4ct ir 24 49011 e9.3 31,3 /, 5 1• rs 5.C( •`-/ 25 Z.2-36C) /77 /- /s4, 54 , As7 - 26 l 01 V4,S-- / 6 S_ / o /• / el yG. •�d e. 27 b Z ((Z. / f 7 . s'. _ ! 0 7 etoesc 28 () Z 1 s 2 2 9 0 1. 5 l• /3 e# Ail t,,.w..L, arm+.•. 29 693 )1111 i 1A. /10 , 1. 6y $ !, n. 30 (o33ag- 178 fro 1.0a. .S lit.4;4 i, 31 opy to be sent back each month to: Minnesota Department of Health,Community Water Supply Unit,P.O.Box 64975,St Paul,Minnesota 551640975 E-00818-02-iC 140-0013 Fl-single Rev.10/20C (,(t L-f 7, o©o �� SECTION OF DRINKING WATER PROTECTION Pws l instmotions on Reverse SSiit o Complete Form 1V1�ri Fluoridation Monthly Report(Single Well) J'& O 0 a 0 ' `1 Q1T E vZ 0/0 DEPARTYE ioi aEAlTa Name of Facility 0-P 7 i 1161 . air/04e 14168 Oak Park Blvd. N. City Operator Name(Please Print) Zip Code Oak Park Heights 3'EFr Ag1„Lo&„G.. 55082 Sign Tide Phone# gig 14€111117 1:214;6tiC. 2,10 , f 651-439-4439 Fluoride �it"Chem c (Used��� , _ _ _ y.0.1.0.1% 0. 35 Water Fluoride Concentration 3 m0 Water - _ 11 ettir • /• age 3Amou t of Solon Fluoridation Analysis Date (MU�) �oDugai.) Qf eap���o ti y q 00 a. (gallibs Tested F"luo"rt"de Semolina Point I ii 0 133 Conrp non on strmm on Day# [' 1 2 3 4 5 1 81A.35 _300 1 . $ _ J. 0g s,r4frit �, > r 2 • 1 i /4/ � /".} // /� T�fSrai.. 7�ke., 4 £s-1e.31 2..55-- 1. © /, / 3 T , t-PlAtoSt 5 SA 155 3 i /. 5 • 17 . 3 0-1414-eei4- 6 ¶63Z . I -13 ,- S J. 0 ( s.,4 (y �- •c- 7 ZSCG / 95 . S /-0 z- Pco 544y 8 EON,”---c7 3A (/ _ i . s I 1 , Z- 5.4. E r 9 83 11 1 3'11 1.5 1.03 port Pa.ilt._ 10 S 3 3 45 151 - . 5 1• I V G ove4414m-Ht'(' 11 $ 353¶ / '1 . 5` 1. 05 Cli II.411. f2 113$ 36, 31'7 /e5 /. 0C. .5. q • Zt/ " 13 E9//d. cal' �G /i 6- /. (5 C. /y�-i�{L/�`� 14 6></a7 es- {/5-3 s /d .3 C 1.4 r4%//61f1Qi4LLE;_e__ 15 c 1 -75 / Pig 1. 0 hia. / .•44( 16 8 =4705 0248 1, a 1. /a '1. Ta)Le.. 17 8 5 0 5 6 3.51 . i. s /. 0 $ ClAtAwi Pte'. 18 . 850201 1&5 T 15 /.020 4 . e . C , 19 . 54./1lA 195 /• 0 1,09 5, ac. . -z/.2-)ii-- 20 85597 / $ 1 , s boa G . /WI 21 (g5 8Q9�6] 30JG! 1$C . 9, 6 �.ye� ef�,°uGA U `� J D / C 1 D ! , /e "' /. . 3 Co(J-_ �, / aiat. 23 86 L150 c263 /.s /,io IT P! i 2 U9 CO 53 003 1. 0 /.1% 5. a. . -74/.24-r--- 28 66l a.4( 7( , c-- /,/4 „5-;.4 ,-�5 T" 26 V `7 0-3 a- (3 b ti i. /1c;1./ C-;:170.' d'i ,4- . t° 27 06 713 3 _ Zo _I _ • / 6 Pa-i �..0 s. 28 7635- Z. 0Z f 1. /3 el A / 1. . r- T 29 785o 015 1. 0 /roq 1 , 5 - 30 tc , / 75 305 1,5 l.s() , .s 11 1/ 31 .opy to be sent back each month to: Minnesota Department of Health,Community Water Supply Unit,P.O.Box 64975,St Paul,Minnesota 55161-0975 E-06818-02-iC 140-0013 f t-single Rev 1W20[ (v 1 1 1 O, 0 00