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HomeMy WebLinkAboutSeptember 2008 , -ffi-- MINNESOTA DEPARTMENT OF HEALTH di Section of Water Supply See instructions on reverse side to complete form. • and Well Management - - pVyS lsa # Month of Fluoridation Monthly Report • r g a o c o 5.. ` CO Q Name of Facility Street / u ' /916 g 0 ,°u.A $� , City,. _ County - Tap Code e 06 0 a-14- /2a /4-l-,(1/441- ¢.e.(�y "1A) a411--1 -Sv g -.- Signatur Title Phone # a '� ' 6'at'ee -I-de/ q-07047V-411 6sr - Y3`�-`/1-/31 Fluoride Chemical Used / .- "/ Raw Water Fluoride Concentration Water Source 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/t) System 1 2 3 4 5 . 1 .0 r041- SiseialachAA • 3 _3 yrb / 45 me bXS , S.,:t. l- - s 5 4.36 4 8e 1 11,0 /° /�2..: /3 6 Z 37677 547 50 i, 2/ . ('%li /ii 7 • Z3 , 3O5. t 1 q j.5 j . / ? Ake 8 43670 75 770 Lb /._1 10 . `.3 9?s 9.o 3 /,37 S l}%,v s7-- 11 qty/ 6 7 Fr _ .r'ies; sS` 12 AAtzeitr 12 2`' 92_ 79 a-- 4 . Q 0‘,2 k4rc.�e.f 13 Z 4 Z )3 g 2 Szt O• 3 0 Z. 0 2 ei'et /MIA- r'°,a7 _ 14 Z43 S6 b • 10 24 2_ 1) _ 1 2-6 rLover Pcr1C. - 15 ,?L/ i 7J ., 3,r-) /.�/ y �/r��wjI 16 ,.7y 9e 4 -74, 3.0 1', 9 F/1 I-44i_ 17 . Li 559'5 69 / .3.0 1. / /_ Cc� 18 / d Cs�.�� �;ee t7 Ar• 19 24 103 22 .S _ 20 21 22 23 24 25 26 27 28 29 30 , 31 - y 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 FT- EE-0081.8-02 /3, 3(1‘) °t° IC 140-0013 MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. and Well Management g PWS ID * Month of Fluoridation Monthly Report iga.00(20 5-€-Iit O • Name of Facility Street • / Zi/& $ 0 a/ z44 6-J4 City _ Count/ Zip Code e o 0 /PC - 7 -e St) S`So va_ 1 A nature Title Phone * 1 gj ' P4&< w esl _931 - `/x/31 Fluoride Chemical Used r^ r Raw Water fluoride Concentration Water Source 7/I'3v.l�i�d aYq 0. 3 1 mg/I 10 "?-1— gf395 Amount of Solution • Fluoride Analysis star 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 L 4 5 • 6 7 . • 8 . 9 • • 10 11 12 13 . 14 . 15 . 16 17 • 18 n 19 °/ .?7/ c I , v u7'-M.v //It 20 r © 3 ( &Q.) 3. 1 /7 , CiI-j /I4L� 21 cr4-1z3 69z. 3- o /-09 Cott A (4 22 81S 6,60 93 7 L I. 0 %, 31 % 1 e4 23 816914. 75C 3, 5- /•o2oZ 24 g/7© 78 C 6Q. 3,0 _ J. // e, - / f. 25 5117856, 778 -11.0 1- // G0 rt' n/ ajt"CAI I 26 818 533 677 3.0 /-a 3 S/A. 7.t./J21-e- 27 $ IZ (, ' 33c 2. 0 ii 02._ /hits "wk. 28 19 ? if I (v 13 2. 5 i t O i T /i,d`' 29 3,v(,4/0 /..59 1 Lt. 0 /4,03 �/ r- 30 807.1 °Z9y 65.7 3e0 J., gp,. S.4, . 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 F HE-00818-02 St l 1 11 "O Ic 140-0013