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April 2010
L s 1 isii 1 . • eraser puppy and Well Management u A M M O A..1 0.0 4~1 1. • ••r.• •fir••w.r� ■ ■•.� ..-.. ...--._f PVSS ID R Month of Fluoridation r / 00 . ptiL .-- .. . a®'o • Street 6/714;:e Ve/e/j//5 cam► r Ciatd 0 CIA/C44•4 fi"e"tfild4- . Vet411.14,1_. ..S.50 g . "--- Phone # Ru Used Raw Watet fide Qonoenbatton South r0 ICIc/I/C`i 4 Ci��� 0, 31 � vZ 1/936/ *--4-6147-7.- Fluoride of Solution Flu ide analysis -Meter ''l•' or Compound Tested Fluoride Sampling Point Concentration on Don Data (1000 ggaal.) (1 ) -Day (gal. or lbs.) tom) - SYstem . 1 2 3 4 • 5 . 1 yg9O.5 • 5�y v7a5 • l,<7-'3 _ /r 'F —) a • 5'0 6 4 ,� `s�✓ /a I $ . "`4644t • 5 1333 X0$7 i. /� I l 1r1 31S 3 gs, /,S .// v38"� �� / S'" RAC ( - 75- S't 2,5 1. g3 Cat Alt( 11 . z L q Z 10 ri - 2,0 1 , 10 .rls- t2 • 7 Li 7 '-155 .2.0 1 25 . T f�4 13 vZ 719 7 - ----- - _._-- - 4 i, 07 1241_ez1J+.R/ :tom 71,1 , 14 - 301 gf - 2'1gl /,0 15 . 3„,.. c, c20 U fe0 - . 17 730 5-011 03 - .G /a' /5 tteutt 1t � 18 41 7 i_s'- 555' . a,5' /., /,? 19 SAIL 576 .1a5 /. /7 22 5747 il 76 q,o . /o/l � el/ 's 21 6 ?V - o/ 7 3,0 ./, 04/ up, 2r1e,e4c*etir-s7 22 68w8 y 41"/ .aa0 /. /0 CI, , , 23 7O3 355 /- 5 /. /3 , 2 4 7 Z / 3/if-' /.5' If c2,a i9� s 25 /.J - /•16.4 26 81� �5/ (2. 0 1, a TeA ; -'-e't4".. 27 .8310 teal 0. 5 1,05 ).1 re 7--4,u2 28 $b37 3a7 l. .5" is 6 5' C',insin . 2s D/ . - 375 /, 5 - /131 . a 38 � 1i ' 16( • l.0 . /./5 P 31 Copy to 1be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.A.Sox 64975,St.Paul, Minnesota 55164-0975 /40. /411Z r ,S,coo 1 L . - MINNESOTA DEPARTMENT OF HEALTH • Section of Water Supply See instructions on reverse side to complete form. and Well Management pws 10 e Month of Fluoridation Monthly Report / D C 0 V 0 c-Q d / o Street OIMeme t Z "ii/1/ 4 .c� lattit Ct is I c//b ' 7 L ,a 4)24 f C y 2p Code eureelf fah 4a 4443 !44-4.;,i `. - 5-50 g.. rra� Peon e /< -& t - } te n sr 113 y_3 7 Fluoride Chemical Used „ e few VVater Fluoride Concentration Water Source .7i...101,444,0_444-441,4-c_ eke....A4 ,:: -Ii-%. _ 0. .19 Ingri 'Iv zie .A' _1.- .. ... Fluoride Analyst's -Meter 7 - Amount of Tested Fluoride Sam. ,, . Point Reading Pumpaage Used Per Concentration on Date (1000 gal.) - (1000 gal.) -Day (gal. or lbs.) (mg/I) System 1 2 3 4 - 5 . . 1 2 - . 3 a - 4 - . 5 6 - 7 . - 8 . 10 11 `Gl„¢,eij--0014/- ` 12 /Mitt.RA.. - w13 � 9o • X90 - 3.-o /. 07 s 14 - / /417 507 .2 a.S— 1.ill 7t0-&- 5� 0m., 15 /371 / SA. r5 - ,, -7 C,t 16 /S 79 •--' .�- 3 17 /3 7 t --- ././S el At—Le 18 • 19 . 20 21 . 22 23 / 65 A75 1. 0 _ 24 / 6'?'/ 0•02-7 I, 4 25 x/97 a / cs. S" 26 ,23.3y 137 a 5 29 3077 H I 110 - - 30 350g. , Li r1. -),0 . 31 - - Copy to be sent back each month to: Minnesota Department of Hear,Public Water Supply Unit, P.O Box 64975,St.Paul,Minnesota 55164-0975 R.Ic HE-00818-02 3i 50S)0 00 2C 140-0013