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HomeMy WebLinkAboutMay 2009 4411 Section oT waier ouppry •�� .........»»...... _.. ._--• — -- — -- and Well Management PWS ID# Month of Fluoridation Monthly Report / g Q 0 Q ` d` O Name of Facility Street P//6 (/ OCILA 4'e 6' -4I— may= County 7� ` Zip Code Signature Title v Phone # �?�� ate-- 77(4-176c ,/ �tc . `Ptt, psi- 3 y- (1,--13 g r Raw Water Ruoride Concentration Water Source f9uonde Chemical Used �-�� ��,� 7,�- 1e7, -'`.� ( 7 OC.09 ►nsn `70 *:(-0 C 9� 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/1) System 1 2 3 4 . 5 . 1 Y%/ czL 5S3 Z, S - f of 0150.)-co 2 -/ S Z -0 • •/,o 3 .e. Le. Air K. .A24 o sty 3 4 t8.31C9I 701 . .3,s • /. / 9 •Zeet - /' 5 883 3a& • / os . 5"- / /0 � A S 6 . 7 . . 8 9 • 10 11 12 • • 13 - << /, /r 14 - 8 s 4.4 0 i, (o R'O 3 D0 / , f 9 Creke-t u2 C.e 15 ,v44,6 9'‘,C1 ,9-5— • /. / 3 ,�C1tW S 16 eg5?5` 9'� .© /. /0 I've as ee,- //N 17 5 Z 97.E- C jf .S? _ c'Aa 10 '1,�� 18 S-i-690 ) 9� V S /, s' / -%�' , 19 8 8 7 6 '-1 '7`-1 l 3..:� fF /3 62 ea-w 't 8' 20 88 ( yy / 04/ 1 Z,, 5 . 1j Lo 7- ..e ocr' 21 83965'/ ' °' f*oO . 5- ,/6 6 4.2 C /° 22 ; 1061 . • G 5 .e S-- .,60-eue -4 - 23 8 `/I693 /07if S.0 /'`3 ,fie 24 81,26,4 7 q59 51-o I. /3 7ii. ..z�t.a s 25 89.3750 / 103 �5,0 7a/ / '1) v< - 2s. 67_0-ci o 0 12.5" 6.10 ,e I( 7.- ,�.ir.2.-,..?- v ; <2, y, 0 Peal ,3co 28 87178 r OS Y. .c /! 10 _� 2g 898 I Ho 5, ,/5 `, - 'e 30 1518102 r 5- 1 , 6 . i, 0 ,sh w'z- s---i 31 'F,4)& Ia 2, _ 0 i i 2-i bqg L,'1.a R,D 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 ._ ■ a.,.... .,., / 7 3 33, 000 MINNESOTA DEPARTMENT OF HEALTH ITSection of Water Supply See instructions on reverse side to complete form. and Well Management PWS ID* Month of Fluoridation Monthly Report . C ; tc ©o�® a7 Name of Facility Street / tile' S 07201 c� 15,6)--609 City — County Zp Code ,;l 0 a- fez i -�� � S-SO S 9 Signs re Title Phone # 6,.5.-7,--- C Fluoride Chemical Used - — , Raw Water Fluoride Concentration Water Source C ec_ "`t" t9 Yf% , O1/ 3 mgA lliae 9 i 3f0 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 . 1 .• 2 . 3 4 a y j 3 yo _ _TZ. I Z -/J- Lt" 5 J. y i 8 /// f 77 .;2. W / /0 ; ���.. 6 9�. 37 ( , ..O .�• 0 /, ©A. . 1 5 7 . A9 a.131 5 Q 02.0 1. /7 Gr.4aTi ®o-6ct-e r` 8 e ,ct.3!05'7 71g 3.5 / -/ _ c 9 Z ci LI I•Cet SO7 Z co o & . A i 10 2,` VL.6 C,, 96 2 /, U`7 , /11-014r 5 11 . A`15 y /6 55'G .1,5- /-/ `I Ti- , � ,,,t-/ f2 g„(/6065 619 .21.$ e./1. 5w.A. �� - 13 y6 7a.8 _ (o63 - 3.0 1-05 7- e 14 1176401 © _ • .v. C . 15 -0-i-� y ' _ _ 16 17 18 , 19 20 ' _ 1 - _ . 21 22 23 _ 24 - 25 , 26 . 27 28 29 30 g y .-7 '7 , g P,/�' 9 , v I. 0 4' 5/4 lt.1.. — � 1 . "2. 3 , �+CD 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 HE-00818-02 1L `7IayIC)" Fl ,: IC 140-0013