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August 2010
_ ,jIESOTA DEPARTMENT OF HEALTH Section-of Water Supply See instructions on reverse side to conylete form. ' and Well Management FINS Et* - - Montl, of Fluoridation M /t000a.© ao!b Oak Pa at/ ?� • Onset yl 6 5 OOJ /0u4tk /6. -a • caw ` Zp arl-a 064. P A-614;4 �1 s-,co % , sgnftweoee R # /E' zbete: zk Fuze c as-/- y3 Cf-q Li 31 Fluoride Chemical Used, . Rea vam�Ruawa Concentration a 4/? O. 0$ - M Z Fluoride Analysis • Amount of Solution -Meter or Compound Tested Fluoride Sup Reading Used Per Concentration on Date (1000 gal.) (1000 gal.) "Day (gal. or His-) (mgll) 1 2 3 4 - 5 . • 1 31 t7Z,K HliSr A• O I, off, G44. ito,u - 2 , 3( L(3 c&i5 ,(i t> ' /. / q ,ice 31 70 . f�7 .•a /,428 4 31 boa . .l• o - _kg/ .4 n Air r �Za2 • 5 320%1 2 - Ll 00 A. d , 1.13 . C�ve4.. �' i-e S , 3.026601 - ,3t9 A•o i 97 - ib-ki-e t. 8 333 7 ct7 L.9. / a G .,.<AG- 9 .335(1 • W9 JO -01.a 5 , . , r 10 3 o 55 5 0 - .5 .A t s ,.__:`4 /i44 .1� 1 1 - , 3c10/tic - ' ( `I, 0 j. 15 _v1 i''1 w- 12 311750 ©ti C'- 1. 14- - , A , - C�,'c - 6?- -,. 1/ 14 35'$ 5 `S //5-- , /. 00 _ S I 15 S 3 Z I r? .0 - q bile. .s 3 z, / L, � /),_,L.. 4/5 .0 L!dZ, ► 64)e,sr 17 ? 32O L11r..Il., i/-.../i- 18 36,7 2,5"- Szoo��z, - li 5" a i P iS • 19 g6//0 , /05 • 5 /cOS 2° 31'23 5 1 -3 16 - _. 136. ,is - 21 37667 ,, 031e1 0 . J./A. , P, .6-QA 22 3g i 3 9 y 7aAs a i 0 i j , 0" 1 / . 23 a a -o I s _ 24 3563 / qfa e?. o Ira- 6 , - _ ce 1A 2• 5 3y © a1 ! l / Q 1 .0 / r.'....-/-....e.9,_ -c„6.4( 26 3g5g% _566.. .7.5 !,11 D 2e-- 27 - , /3 , �3oL-re.is 28 10/ 2--V ' 91,.y 29 10'i 3 r� A. 0 ,7%.6 cove-4 P.�r x 30 '{v '/5 , 3G,5 a, o / , Dl �.'. 13,.. 31 - 3 , 3 , . G. . Copy to be sent back eadi month to: Minnesota Department of Health,Public Water Supply Unit, P.O.Box 64975,St Paul,Minnesota 55164-0975 R-•= HE-00818-02 /0 353/©O0 IC 140-0013 • A ♦ .. 'di ' . becuon Or water puppy and Well Management PYVS 10# ' Month of Fluoridation Monthly Report t3:7100,;1 O o�O/6) 04, AAA iiCIA.4 14)4.04 0/15 / W6 % 0 etA Act4,-4 41,414 r Zto Code sail otx.h. AAA /0-4-8164, • vet,eiv,reN 6.--5--o 42- gig Pi.t r e.n K3q- cot3cf i # , 1 war W r . - - a r- d� 15 'no - etime , , Solution _ Fluoride analysis Amount of C mpou T� Fie Sam�g Point Ring Pumpage Used Per Concentration on Distribution Date (1000 gal.) • (1000 gaL) •Day (gal. or lbs.) (rrg/i) System 1 2 3 - - 4 - .4 5 . 1 11"Vpi0 " ?1SS 1.6- Iti?Co _C-3 !J""! 1 2 ti 79$6 6214.5 3.0 : • 3 L[$a0.2. 02 17 10 .•4 5 9 q/s h • 1.s— . 1 . 1'S _ 61 chef enr Ca••-gr 6 9y§,O1 4-14 y 4.0 - 7 . -o,3� . 5354 . , 0 • - 8 Se,4"S i • 9 '5097! • 4i?p .9,5 10 51c23.5 02 6 4 /. 5 . . •11 - 6 17o LL(q °c?'0 12 5i c160 4156 1• S ' • . 13 ,c-0V- ' 14 - 5-•Z141 . Lt3 t 5- f-a) r c ' �.. f 15 6'3 ((, 1 Ail 1 1.0 • . 19 5lv dam.-l45. 16 3rd C? ,-;2s'6. - •. 4_-- T 17 5 ' - IREENEFtaL'r4'er -9ret,t.�. Pale. 19 54/65/, Tl Vi 02.9 20 Pi 923 As-2. 1 . 0 . J3oidtwewS 21 55 yal • 5 /$ 42.4' • 22 55(07.3 252 I. D 23 5'(031/ Z- 6 to 9 3. D 24 566,55 313 /• S (17.4:..- �� �� 25 ,�7(30 3'73-- a, s'" 7 26 57411/ &G. 5 i, s- 27 ,rte 05-' S-D 7 7.. 5' - 28 ckL► (0Y'3 7. S' 1,17 " Gd--j k•-)1 29 'q / / W 11)0 2.0 3a 51(0 47,Y 574 C>1, 5 • - . 31 6, 00ea ! 3027 II.5 Copy to be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.O.Sox 64975,St. Paul, Minnesota 65164-0975 ...._ 12) (0V' 00O