Loading...
HomeMy WebLinkAboutMay 2007 MINNESOTA DEPARTMENT OF HEALTH ' Section of Water Supply See instructions on reverse side to complete form. and Well Management PWS ID # Month of Fluoridation Monthly Report • /$a0.0 "Mai a �7 Name of Facility Street 4/ /6% OC42 Past /6-4-6( - Citx,,. County Zp Code Signs Title Phone , � �,�: e� '( &t 7,)97 ids to s, - y3 9- %'L 39 Fluoride Chemical Used - ,. -- Raw Water Fluoride Concentration Water Source `► 2 62G' e., A ;---------- mg L '17 7.Pa 7 Amount of Solution Fluoride Analysis • Meter or Compound Tested Fluoride Sampling p g 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 _ 7� a 2 , `1784.r2.3 6 73 3. 11 /. 0/ _Cov�2 P6e4.k._ 3 979/ 4i5 702v2 3.S biz/ 5,A, -Ill - 4 lc'7 27 y7 60 _. '/r S' _Bads L✓e//.S 5 ,gyp 224. 2. 7, 0 .1/7-C_ Hoi-/Ate_ 6 ,Alyj8 ISS°9 379 3 t- 8 98aa9q 71O 3,0 _ /604 X . E ,C , 9 , 9801 `17 9' w 80 3,o / a�. S.A , C , 10 , 183g/5 01 3 6 3.5" . 0 c 1,/a,F',ie7 y.-Le.w 11 . 98LJ ,58 873 Y,O /, © V 5,/4- �l. _ 12 38541301 7yg 35_ /. / q . 7 -10-&d .5..ta: 13 /8 (0.2.26 78 8 • 3-S 1. 30 S'./1,•p 14 /87// c6 898 t-/• a /. /a- J ~ 15 183 1/ 0 11 a, 41.5- /• Ll S" 1- 4.44. 7-4)2.-e 16 "88978 868 y, o . 0 / el,"17 981836 8S'8 • y, a I, 8 r_getA__. 18 99£S 3' /007 y-5 AO 19 F p/ ��/ '')F2' sc2 /...?a 5A pp 20 .I?Oa q `/b 3 .s, 5- I /'-- ,4t4/s 21 99 3553 $'-1,9 y, 0 ,.. '?c ,03 7e-x-77,/+-`- 22 999701/ cS(S q• O I. Z I 1/% -IC 23 . g951 79 755( 3. 6 1. �0 L►t1' /TELL-- 24 - 9q f0 /.23 6yH 3. 0 1, 05 �" 25 996,8541 7j( 3-S- 1.05' 5,A . Z0-12-) 28 91 d 3t 74 3 j . d1 S,/ - i, e T 29 998 r 9bo ci.5 - ,. 10 s�;-af � 30 000. - i i0 a 1, 00 ' 31 001 L!_I 1 C30 3,S" _ I,07,1 _r 'i// 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 F- HE-00818-02 Lr aGp Y,O 00 IC 140-0013 11 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 • ` 0 Y�r`y�i�1- �D p 7 Name of Facility Street / V 11/6% OCZA ,14 2 ._- City ,, County `" Zp Code el Oak "MA- At 'ti / ueni,gym 6-5-o 5 Signature Title Phone # j{ •ir` u 76-1X-9/414-4‘ C.57- y3?-r1/ Fluoride emical Used ., _ Raw Water Fluoride Concentration Water Sour-- /It a / a mg/1 70/.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 1 2 3 4 • 5 . 2 . 3 • 4 • • • 5 • • 6 7 . • 8 . • 9 • 10 11 12 • 13 • 14 ' • 15 16 17 18 • • 19 20 21 22 23 ?a/ 3 7 _Co 24 25 26 • 27 28 29 30 31 : 70 /376 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 6.Or0o0 IC 140-0013