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HomeMy WebLinkAboutDecember 2008 ., MINNESOTA DEPARTMENT OF HEALTH .1 Section of Water Supply See instructions on reverse side to complete form. and Well Management .. Pws 1D 41 Month of Fluoridation Monthly Report _ /.?3(.9 Oo - o .c, o S Name of Facility Street % A ,64GC , ow _ County r Zp Code Signature() The Phone # k_ -e � P-t, tre�C �r/v � 71/ -1- �s 7 - 47-�7- W3 y Fluorieemical Used C�jam/ Raw Water Fluoride Concentration Water Source / , , i ' "--L� "n c;g,z, d. /8 m9A V CSC(� c Amount of Solution Fluoride Analysis . et 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 q 5 . 1 83E157S 1/ 1 s 5 - 1, 17 _T� ' A° 2 ie.,�s?- 1i6 5' 'Cl .. r I. .2) /if s 3 . 4 5 $3go76 Wo7 .2(.0 , . l-a y 5 eter 6 3314.1$ Ya. 1, 5 I. / /1e;fil 7 . ) 6 /. 5 /.0 C,- �-f1. 1N-7- .` 9 8408/9' 10 8,41337 4 438 Q-0 /,,a0 5..4, C-a- 11 . 81118 .3 y Ii�'� • a,0 1. /a, �'--& -- 12 $ yaAa`I Vol .2'0 /`0zo. 13 gj z733 :boy - 3. 0 !, b !/ (, i4 3 .0 - ? s . s . I , 16 air 15 $ 3(oG1'7 _ x'81 36197 .. 181 _ /• 33 _T P..I 16 $Liy l sr/ 487 4. 5 _ /. o/ S;A. e-41-04--- 17 81.1q685 50/. -a.s- J.3c S' 18 895187 q6;,... Q-o /. o? _ .7 , / `, _S- W 19 VC/C-677 S-�U ,9 /,4 V- CA w '�. 20 ?q- t� 10 .5-' z. Z :s . �� �' 21 (a 1.' "2 Z . 5 L ©7 ' r.a.'d' /ft ' 22 84/706 435 , 5 j. o t"- 23 8'17597 _ 531 . 6 1..16 t" 24 4 5I 3 3 53-(0 7-c I-17 s_ 9- -fir 25 55 4ft kei ci 1 ; 4 - Z 30 C, #4-1-L_ 26 4.5f7 147 Z 1, 3 3 C,I.-* //4-tL 27 $ 493o0 74 t . 5 i - 0q g 28 $ y O s 00 2. O / , • . COUP /GJ - 29 55041,08 LI 0S cc /es25 ,s-- /e ©S .44.4-ieet7L T � � �50 750 Spa � 31 7 5/ / 8© l g o 4,0 /a BL �Q e a-- 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, 7/6/ ooe . MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. and Well Management pws to * - Month of Fluoridation Monthly Report t , /6'(900c90 . /0-emsp o8 Name of Facility Street c,/ 6 s� ,„ / �� /Z /5 A— •civ . (� g CJ / z�fif County Zip Code O -�fe_ -V 1�, i►ti_ • 650 5 --- �ture V o � � /� � Phone # rile g d /-'1 �?�v-74. F in &,s/- `93' yL!39 Fluoie emical Used _ ,f Raw Water fluoride Concentration Water Source s 2.60317. .6 0 3<( 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 6afo •S 2 77 if 5-" • /1. 7 ice-` do-ea-4y- 2 d6/0,5- .1// ] y 545- �* S //�, ?//a'l ��•t4( S 4 a,a0 547 . a e- -. 1. 46- Cien -c,. ePa— 6 - 7 • ' s 9 • . 10 11 12 13 • 14 ' • • 15 • 1s 17 ' • 18 ' 19 20 , 21 22 23 24 - 25 26 • 27. - 28 29 30 . , 31 6...1 16 0 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 -.. /i $391000