HomeMy WebLinkAboutOctober 2008 ,.._1 MINNESOTA DEPARTMENT OF HEALTH
Section of Water Supply See instructions on reverse side to complete form.
and Well Management PWS 10 * - Month of
Fluoridation Monthly Report •
i g,9 0 0 a O ek c g
Name of Facility Street a� 6 n'_v` r
City - County - Zip Code
Oak /9,e/2,4 i d a 530
g,�re�
c� ' Title Phone #
9tói 1=u: Z4-'- 1)1.4 to$7, ii39. 9(1 39
Fluonde Chemical Used „ . r C`e'`, '` Raw Water Fluoride Concentration �Watter�Soourrcce
7 ♦ / r/ '�'(4.. ` --e-e c_ yx. 0° 1 7 mgn 'Val c
li A 1.29`f 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)
1 2 3 4 • 5 .
1 ISAAO 58 761 3..,5 / 1 ?y --
2 8a 5-8 70 0 _ 3, o /../6 :,-;"Uv., ., i1,, wv;T
4 (A .Z. 1 b 3. / ,
5 Z - D -lr 1 . 5 � .
� Zi7S , SsZ 1
6 8e253 /a 6'5 C., a- 0 /- ;-"?..& - P
8 8.1 e Si-Cp _ .5"95 •vr� , /. 5-- Si , 74J-24-11-9 .0472. 70,50 / 0 .2e a . J 3I _ c Ce
10 32 71 (®b - '3. () /. 2/ � 4-tc Aifi//s.
it . ?(z.. 3 z H 3 Q 1, / 7 C! h J I
12 l 74, / S . / • 1 , • 5. jm-e-51'"
r
13 . _ 4. ; -0 r .+ ,. JL � ..
14 . 8a9375 . • 530 07.S • 0.7 6 `
15 F(303 ‘C1 5:7s- .v. Ste. . /, 3 I ,.�//prr r c� 4.. Sr.
16 -3 o c s7 5- 67 , s- . /• a.3 '�-�r`�,1y. ? c•, o -
17 ? 1 r7 7 _ 6Th.a - ,a.S'" 1J / 7 j'eow,�.. <.,aP�c.
18 i3 %q / 1 0 2 - O f`-. ( 154.-K C,
o - v /. Z4 r'; #LL.
19 32 9 ,_ _ Z
20 83 3 o 0 3 , 5/ . S . , /t, 3 5 f&
21 8'33 9'8-3'. i a_ s- . /- 2.,S s, a . 4�e -
22 33L/055 567 .2.J- /gal L /e„
23 83 ' 55 1 L f e c �.�t• 6 /e (4fl
24 3 5 0' t 1 o[.5 / at 1 25 3S5 / 0 46 $ Z-0 , / / �Q p
26 $ 3'5gY5 , i gs 2-0 /, .0 -
27 $343417 , 50 .2. ® /. 7` ` 0,0__?
28 S . 1:0 (m 7 , _ a2.0 /®a.5" ,�'
29 837371 41 0 4f 2,0 h /s"` ./ • sei..o
30 f -Z7 R"�'f 415 - (.0 • ifrcv, . 0
31 ; ; .. ,� 3ev
V5*
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.. 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
MINNESOTA DEPARTMENT OF HEALTH
Section of Water Supply See instructions on reverse side to complete form.
and Well Management p ID# Month of
Fluoridation Monthly Report O 1 _ f r o g
•Name of Facility Street (`� C�C
lYO 0 .1 JJ
County Tip Code 0 al2 P0412 li-elitt: IV
Sure V Trtle Phone #
1 ,16 Aj—eieelp_ ifthei. 7i10 1/02-e42/14.," 6°,1, L{3- L/d3T
Fluori e Chemical Used C Raw Water Fluoride Concentration Water Source
. l� _
41&4103 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/0 System
1 2 3 4 . 5 .
1
2
3 •4 • •
5 .
6
7 .
-
8
9
10 .
11 ..
12 . .
13 .
14 • - _
15
16 l_
17 - •
18 ,
19
20
21
22
23
24 -
25
}
26
27
28
29 • .
. ` J
30 _ �j
31 7 6 qe5 f e,OO 2'
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
Fl-,7.