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HomeMy WebLinkAboutJune 2008 * 1 MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. and Well Management PWS 1p # Month of Fluoridation Monthly Report • Q 0c2 O 1‘)/xt_ Zcics Name of Facility Street © aitc1. .61/eV-al - • Ci County c 1p Code CA 4X 0404 ,® - 5:5-0 S•: -- Sigri6ture U Title Phone ' /i-,¢-1e7 A.-6-ec� ?r/a, r- o i-xa-2t. 657_ L/37- 4/4(3 / Fluoride Used ^ . _ Raw Water Fluoride Concentration Water Source 7 • • / , • ' cp 0.5/ mgn 6-1c11 d -.1— /ip q�, Fluoride Analysis 1 Amount of Solution 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 l arr $3 C2 scl 4- o , 6G Cov4e pack 2 11A 0048 13 2.5 Lt.5- ,4 34_ per. 3 L3. 1 0 3 1 (0.28 3.5- /i1 i in A M4J4-- 4 I$34 3 787 y. s-* • 1•a ( A, - . 5 .t 'o - „ 7 4/" /%. /r'_, 6 / <- s' 6 9:` , 3. s'- _ /. I t-- . 444‘.+" oc•.,,'i°L 7 • ./ - 4' - 6 7R-. ?,s` /, a < me- s 9 / s'Z �f7 S-0 ' 6/D o /- 3 -S.� ; ....21-- 10 /,; 7 /go Ca 7, .S- l• �� 'al}'�^Z� " '"1 11 . 1$8/74L 7ci. . ' 3.5 /.j'i 1 ) `..r.� fi n 12 188777 58 5- :3e0 . /. 3 ret 13 753 Sc . 4'*0 I. �+ 14 i gv /4 - (�S 3.5' ! . 4 1 CLoo r 4 e k 15 Ig03z� (05S( 2.. .5- L J,O I�r,e1� tit_ tp.sf ., 16 /4/1 51 7 76 s +-!,s` i • �t . S-•Q. zJ..,e-a.Y-'- 17 19 6 a. Co 75 `40 I. 37 T� .. 4,xery' /Se/wit- 18 !93 0847 . i'tr./.7 4e,5- _ 1d35 Qt r►10 I� --e-a- .. 19 /f40 $ 1 "060 S IP / lam, a-w,,! ,aL.Je& .. 20 /911818 7o2.9 lir S". /1 W .4 , 774-e 21 195733 _ 9/S tiro /.Q6, • ' / , 22 i 9&e ,$ 895 r r- `'- 3.2. 1 t.23 /97117/ Y3 /,. /y T.,� ie€ 24 /9 S 33 y C?3 if,0 , /• e77-1 -1 25 l913Qi 94' 5.o /. 417 ' ' 6`tc''12-1- 26 aoo435 1 to& s{5- / V S.,t L o _ II 27 .a 0 15`1 ? " i 28 4o2.x3 , qfl 5. 0 1 , Z.3 �- - rl 29 Z0 3 1 s 2-0 3 0 I 1 [/ _ C2.17 frrt,i4_ _ 30 u.40 76 %IA, '.a . te lot Tom. .ct- ,°.144f1-- 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 xE-00818-Q2 ,tV021 $q3, E'©c) Fi IC 140-0013 ffl MINNESOTA DEPARTMENT OF HEALTH a . Section of Water Supply See instructions on reverse side to complete form. ' and Well Management PWS ID # - Month of c Fluoi idatlon Monthly Report 8 9� ® g / ©00 Name of Facility Street • / yl(S 0cs- dact-4 6-e City_ '� County k. Zip Code - SigC�re ��I< °.6 Title irk%YGa Phone # • Fluori a smite! Used NI Raw Water Fluoride Concentration Water Source 7 , , ,, '. ' ,v Y� c-- mg/I ' 14‘a. 77 7(7G 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 • 5 . 6 7 • 8 g 10 11 " 12 • . 13 ' 14 • 4 ' 15 . 16 17 . 18 , • 19 r 20 21 ✓ 22 23 24 . 25 26 1 27 28 , Y . _ 29 _ 30 777 /7 o0 0 d . - 31 Copy to be sent back eacii month to: Minnesota Department of Health, Public Water Supply Unit, P.O. Box 64975, St. Paul, Minnesota 55164-0975 Fl HE-00818-02 IC 140-0013