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HomeMy WebLinkAboutJune 2009 • MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply t and Well Management See instructions on reverse side to complete form. g PWS ID# Month of f q Fluoridation Monthly Report • aoo o 0 ` Name of Facility Street • l We' 0 C112 4,IA -tf City County Zp Code 05 omit Pci _ , /4-t ; a,2 /Z! �2 r` •5 Phone # , -, Sign- re Title Fluoride Cite • Used u 0 „ Raw Water Fluoride Concentration Water Sourc/ M 6.08 mg/1 —61e ,9.917h4 Amount of Solution Fluoride Analysis Meter or Compound Tested Fluoride Sampling Point Reading Pumpage Used Per Concentration on Distribution Date (1000 gal.) (1000 gal.) Day (gal. or lbs.) (mg/I) System 1 2 3 4 5 . 2 3001 , 0 9 GI 5-0 • /S /i , 7V-e-r-c c4-- - 3 301BR7 `l '(7 S.0 1, ZZ G- 4 307 a. J 08,5”. S, 0 • - 1 . 0 3 5 3011 J ill / /v. 5'.0 /. 3/. .� u.-0- 6 3c, cIgZ /® 18 5' 1 , t3 . 4, .�,✓ //-i/s /4,14 7 • 30 ' S3ct .�06 4 0 / i (e) 5" 111 8 3t.4--- _ 1, 0 i�4 At--- N/4fi s 3v S`S 7 h�c� /a /,3� S�,,o-4^ r -� .c,rs`S- 10 SO8'3SI? . 7a .3 3 _ s"-.- _ /,_2 ,V Soi/i..-1r.,4 C/4 sr 11 . 30 9/6 74 / 3 ,. U /„ 7 e" =ui p w.e 1L 12 ' ,, F? 3Y S-'' 5;' 7! s-� /, A 7 ,/$1,. - RfAk 13 14 Sr : /.�Y • /o l g ` a • /.. .) 3 /1,1'7 f-/oil 15 31,1688 / l 0t-I' 5.0 if c2e2 7"1.14 /,.� 16 3/3 6416 _ 15 4/..0 f,• 0c. S,A, 17 . .A145gi q 3 ci • Q . S / f C1ci.,e,r cat K. 18 7S / 5.:2 v ( 7C, ,. S` 4 19 lliilet-z /4' /4•1- C _ 19 3/6 /S $`lam. .S'! /e 3 -€ 3/70'49 9 Li} s-- . 1 •C - 21 31773e2.. X33 3. 0 , J. /6 S. 22 31,84488 756 3.5 1 , 31 herptea j:ti_taC , 23 319 L 13 9d.3 4 1.0 1 . 1 0 S A 24 3/ 75/`/ /o/ -- 1 , & _6 ► -Ci..4(„ 1- 25 26 27 2 / 7 4 2d ' 1 °4, D , b'" ii/i /, , /1?6N.m4b .1 28 3/ 9 (o?D o 0 . . /, /7-- kRg K. A 29 30 19Coa0 0. . e_J C 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 HE-00818-02 o/ %6G,000 IC 140-0013 1 di S OT wager auppry and Well Management 10 Month of r Fluoridation Monthly Report '7 Name of Facility Street !"Q-t 0. /q/6 '6 0/2 ZZ City Cow, Zp Code Sign-, re This Phone # `% I I ` t1U �-tem it Y3'- 94139 Fluoride Chemical Used - Flaw Water Ruoride Concentration Water Source j . GZ -4P�?YZ, C e o j mgil Ili�+ 'V �® Amount of Solution Fluoride Analysis - Meter or Compound Tested Fluoride Sampling Point Reading Pumpage Used Per Concentration on Distribution Date (1000 gal.) (1000 gal.) -Day (gal. or lbs.) 0119/1) 1 2 3 4 5 . 1 • 2 . 3 , 4 . • 5 6 .• 7 ' 8 9 - 10 11 • . 12 • N.13 R19941/ /J3 9 - 14 • `1 sk,4 • / L3 • S I r .9 cyttr pork. 15 - i6 17, - . • 18 . 19 , 20 $l9 q 7l.'j l 4 ID .2,0 . 21 -1 et 7 lj ' , 0 0 •22 Cis y 23 s 40 0 .:2 r 47 eA.7 -„ "L 24 X67 , , _. 25 90 e 7 a ' 9,2.2 .`i. s /,/_2_ Act.., go-0,6),7 q o a, Y•5 ', o/ Gtzw :ml.-n 8,Z-G �' �D3S'(vd _ q33 `1 ' o l• �� ��'c'28 go115 X9411 mfr �• v rgic 29 -;9'6. 3 /t l 4? 6 '.© , 30 ',, . 1.1.4-7`' 30 4100 7 &7 3,3"- . , 1r 1.41 e..eik /1'4,41_ 31 Copy to be sent back each month to: Minnesota Department of Health,Public Water Supply Unit, P.O. Box 64975, St. Paul, Minnesota $5164-0975 1 Cl 0 L{ 45 2,`Z 7r 955,00°