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HomeMy WebLinkAboutDecember 2009 1.0 MINNESOTA DEPARTMENT OF HEALTH Section o1 Water Supply See instructions on reverse side to complete form. and Well Management F.. # Month or Fluoridation Monthly Report ( f )s a 0 0-C / . --eA-_ o q Nerve of Facility - Sheet 6.g Oa-IL , /3.i - city_ Code 0% Odh "11412 � ✓2GG Title Phone # '/ / K ('1/T -ett. ef:C i,1) 7o�- rc cocci- Y3 ?-Liz/37 ..: a,cr.Q'.`/lp D, ca, O Ingn w 331-11 ,-11 Amount of Solution Fluoride Analysis -Meter - or Compound Tested Fluoride Sam O g Finn Reading Pumpage Used Per Concentration on r� Date (1000 gal.) - (1000 gal.) -Day (gal. or lbs.) (mg/I) System 1 t 2 3 4 - 5 .r 1 2 3 , 334767 , 4:426 3.0 _ 0.18 7t /V 4 - q `174,_`174,_ 02. 0 Q059 5 3,.1 cg s'6 y ,35? /, tS • /. o s7" R P4-r c 6 13 q• 4'i' /0(71 - 4/9' _ . --1/0,e 3 ,, 7 *. _ 336(267 609 3.o • /. -2 r7" . G �. 9 " 3371470 / ------ / o1 10 337655 Ll85` - c•0 10L/ ' A , c , C , 11 . ' 338130 47.5 - 01.0 . - 0,'W.. , 21 co-ezDA, .7 . 12 3 5'3 L 0 2-c) 1 i 3Z-, i 4 ((C'f. r 13 3 39. 0 3 i 5-0 b- 2-a L 1. a ? s. . - S+ 14 3395 / 7 - 14-79 a.0 /4,07 7-w P-� ' 1s . 3399a $ 4 1 I /d5 097 , Acearaifut- 16 3 0 30 3 7 ' •5 B A..Let ,� �` 17 3W0935 8 ' . 5, ' /. Q1 i8 39 1 Li,a3 x488 . a.0 .c/a- Pet -ei`_. 19 x°1178 ( $ /r5 f- 3i �5- 5 29 3y�3N5 6 il 02.S - . is 3 Y ' 21 34a 79 8 LIS3 a. 0 • 96 7 . 22 _ 3‘131811 y & lc� /. .2..c , Se A, g,°�- 3L13(o .S Toll V 3 _ °,) t ._s-- 5'4 Gv 25 3 1-W,c7 . ya 471 - /. s' i_ / ,? Y- _ -SIX 26 - I. era-41U /644/2_ 27. ._ • 23 3L HItict7 yLf0 _, o - 2s 1 . 30 - •• 1 . 31 Copy to be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.O.Box 54975,St.Paul,Minnesota 55164-0975 F1-It FIE-00818-02 IC 140-0013 e On ar wham puppy _ and Well Management - Month of �9 t�w8 i0# Fluoridation Monthly / g O O 0 - 6 ? - Name of Peoirdy Sheet . j 1//6 g dC112- d2-- 6 r Zp Code atY,a-e C71 P� ,�0, -4 , 1,,)a.S. f sC oge- Phone�y g-661//y. l� tpt.��'�Water�yC .�y�-�010 7°�,3 mss/- Y37 - `(y39 Fluoride Chemical, • ' / e .r C Row FluoI de Water i , a 1 , , : '76- 0./6 m9/1 -7'-e,-, Fluoride Analysis Solution A ott Tested Fluoride Sampling Point Pumpage Used Per Concentration on Distribution Date (1000 Reading) (1000 ) -Day 9a1. or lbs.) (mg/1) . . SYstem i . 2 3 4 - -11 5 . 3 4 . • 8 , 9 yob • 3I 1, s- r 10 11 ` 12 . - . . 13 14 - • - 15 - 16 . 17 - - i8 - 19 20 - 21 _ . 22 V . 23 24 - 25 - - 26 • 29 x'3 0 _§.4-10 - ► _ !o / ^ > P. t o 1;0 G' ' sue' 39 6a3I . 8.9% • /is- /.3; 7` f 31 " 6SRf3 5°7 /,5 99- 1 /3• 0 Copy to be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.O.Box$4975, St Paul, Minnesota 55164-0975 F