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HomeMy WebLinkAboutFebruary 2009 MINNESOTA DEPARTMENT OF HEALTH • Section of Water Supply See instructions on reverse side to complete form. and Well Management PyyS ID# Month of Fluoridation Monthly Report ,, / ,. rOct Name of Facility Street • . Pv1& $ Cc r ,E. 2( City _ County Zip Code Cf 0 % -tv j✓ � S' na t r Title / Phone # e- -- 6s - '--ty39 Fluoride Chemical Used .-'/ GL.t� Raw Water Fluoride Concentration Water Source f °t- 0 5 mglt a. 46.2-173 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 2 0/62.387 al'-1 /.o . /-ao , T�.e »ti _P--1 3 a,6 78 3/6 ! 5" /-3 g pi .em-�- 47-� 'J.q ,0 J.3 `� �� Ih77 4. 1 z z . v /_ t9 s ' - t i T 5- / - /i G 451.94. 17 .2. 0 6 :) ? T 4crotta-- 417(a j l 1 lil .2 i0 /gig -508 / , 5 1-nfi 5A )t c / © 1 Oc ( z. o . 117 pi a>o ' s4Z L33 Zv j. Z £ / cL V 2:3 - -2. 0 JA 3 7,, v. r, -.15i' '1 79 c:2 o i j i_I I .2.0 1 0 7 n J,vr, 70 W i t L-156 :L. v . / -4 10Ctil • Sea Z.. s is iz V Oi4.i. *A- / 3 .1- 0 /- ? s a.11r OL 7<9-018 6 /‘ o &0i- 6S /rou re't p° �- Z1 3 D l / . a s i„ , o• IIEINIELF A .z 3 EMIl'MirliM CoiAii Ave? 29 30 , 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 l,-« ...... A^".e. IS Ill 991 ) ()C° 31 MINNESOTA DEPARTMENT Water Supp HEALTH • See instructions on reverse side to complete form. and Well Management PINS 10 4 Month of Fluoridation Monthly Report , / (69000 . / -�T /e ©q Name of Facility Street • _ 19l6 5 C) �-h f��-c4 /�-_67)-ce city_ , My ?gyp Code C-4- 1 °`Ir- Ptk/ ec 1 e.. r.L- , yL 5-5-0 $ 9 Sign re Ai Title Phone # c Pc��.` /c: rvz-e ii G s•�= - y33 l- `f Gf. ) C Fluoride Chemical Used etc c.21d Raw Water Fluoride Concentration Water Source /1-94/L06-ea"- c95`7o C� /' mg " ,eej , (b (o 140. Amount of Solution Fluoride Analysis - Meter - or Compound Tested Fluoride Sampling Point Reading Pumpage Used Per Concentration on Distribution (1110)Date (1000 gal.) - (1000 gal.) •Day (gal. or lbs.) ( 4 1 2 3 4 _ 5 . 1 ?6,46 40, . 4g3 Z. O • I, 1.s- 5.A- (Aj 2 R4.49• 1 5 355 /e 5- • f. .?o ).•L '`P z - 3 sa 4 6 7'.3'0 0 57 0. .sue -4 0? q.y,f.--rrf tZe 5 J 6 - 7 . . • 8 9 • - 10 ,_ 11 . $61$.59 351 .. /os 12 ' 13 . 14 • 15 16 , 17 - - 18 • L. 19 , , 20 21 ' 22 23 24 - 25 26 27 28 b f____-_____-_._......_....IP 29 30 . 31 Copy to be sent back eacti month to: Minnesota Department of Health,Public Water Supply Unit, P.O. Box 64975, St. Paul, Minnesota 55164-0975 / "7/a , OOo