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HomeMy WebLinkAboutNovember 2009 J i bwC My� WOW jailFluoridation and Well Management *' _WS 02 Mor_h of Monthly Report sg an no .o av-: `o 9 - Name of Faclay Street aty County — 21p Code 4ceilio,10 CLIZ- nt•tA/V-ezeta: Iliaii/tAli SS-0 S a---- Ai phone z - '(3? -VI/37 Rtwide tai Used , r Haw wake Ruodde 7.7die 1 , % 'i '< -- `� yx 0. /0 -/tot Amount of S Fluoride Attars Meter - or Conpound Tested F de Point Pumpage Used Per Concentration - Date (1000 gal.) - (1000 gal.) -Day (g ) ORM on SYsteni 1 . 2 3 4 . 5 . 1 c1.894a3 - 4449 f .0 - r ,y/10 .311 ` - ' 2 gVicl iS 1-. 1 J OS (' r � -' / 4 , Y o X12'' . et". ..2-,c› - lc 0 7 r� t.-;et�r- s 991363• 35 Q42 _ - /o /47 . c s ,5 &/ ` 7 . gg277 . 3c 11� Z-0 - c 4 All- $ Li 1 L Safi Z .© I ,./. r(k, , z i-c.d , 9 "c19.3aLi 4, 1153 Q.5- /. I 10 _95347.5 413 ,Q ,�Q �`fa Zae. 11 . 1 9 () 53 l ` Z , $ , 10 S..A. t s1- 12 9R*46©v2 9 I a 4.. /. oj. . 13 L555 !51 , 59'1 3, /c08 14 - ?9S-66 . 5-':3 3• J. / AR., s 15 - . 4i 6 4,7 c'" 2.Q - /,a 5 p - 16 1'166 !. xI52. a.c� Ja/ M.-€4{ti�: - 17 Cl/71 J . �6 ,-0 /. 0, r �-,ae 18 91. `7 6 5/ 7 . ,5 , J. l4 , , a 19 '198 / 0 .5o ca pR.IF O. 96 7f 20 198657 o a. - /,o b r. n.,, , i / 21 9 9 I - 3 0 Z 0 . 1 , /9 CoLrcr pai-fie. 22 A°‘ 9 4 3 5' 4 1 Z -v 1 . ' > l 1 23 99 "I4 $ '13 o.5 /! O?-- P-. 24 ; oo036k 14 /g its J. /8 u , fe 25 ovo897 53 i -cl•s" r.. /0 7 ,' .. , S c 25 00141,a 32 145- I„3 7 S 27 001596, 3 7. 0 1, 13 o., —Pleb . 28 0001,10(4) 0 4 5` /t /4, .#.�.� «� ' 29 f9D X566 o¢ oz, O 4-40 9 4`..et C 30 V'Q a5. [ 4 3 3801 - ez f o . 1.3O ____ -.s rt e' _.._ .._.- � Copy to be sent hack each month to: Minnesota Department of Health,Public Water Supply Unit, --. - P.O.Box$4975,St.Paul,Minnesota 55164-0975 ..... ....,,..., __ /3/ 5/1, 000 . ..T MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. and Well Management PWS is# Nam of Fluoridation Monthly Report / g i D 00 c9 O / ` (© r Name of Facility Street . le//l0 8_C " City County Z Code . sgiCijrea - If oe4 "a--/A 7 _ ter/' - i coo s Td a Phone # 9-W f'? &b �1�,A ,--,i,,,, l 57- V39- Vy3? Fluoride Chemical Used Raw Water Fhroride Concentration Water Source .yam G �y 0 c /( rr�n vv-e1 rt . 35,3$5'3 Amount of Solution , Fluoride Analysis or Compound Tested Fluoride Sampling Point Reading Pumpage Used Per Concentration on Distribution Date (1000 gal.) (1000 gal.) •Day (gal. or lbs.) 019/1) 1 2 3 4 . 5 . 1 - 2 • • 3 • 4 - . 5 . fi _ . 7 . 8 9 . f0 . 11 " 12 _ - • 13 - - 14 - 15 . . 16 17 . 18 . 19 • 20 21 3340/ 5 Jb_ 0 _ tIi _ („jug /le✓IL, r 22 23 24 _ 25 26 27 _ 29 30 33 Lilym Ia. _ - d . 31 Copy to be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.O.Box 64975, St. Paul, Minnesota 55164-0975 Fl-`= RE-00818-02 f1 C� © © o IC 140-0013 ‹,L U