The URL can be used to link to this page

Home My WebLink AboutJanuary 2007 MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. ' and Well Management PWS to s Month of Fluoridation Monthly Report 007 7 ta,a00(9.0 944A, . e:.Name of Facility Street City County Zp Code (1,41 rita4 re-4 7i-exi-Ao Signatur 7 7 Title v y�% Phone # C '�-�� .f', ie 2z107,4 -e z,2. i 65( - I/3? - ye/3? Fluoride Chemical Used Raw Water Fluoride Concentration Water/Source. 7414.4 "' .&-c 6 u�Ge`G C G e-j`i za 0. 38 mg/1 + .ei�t 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 V LIa'7N qS9 02 , D • // /5 5,4. 74)- - 2 914r776. Sock 02t 5" • `.O C 72?4-i, rt f p44r • 3 4115-42S / 5©S a, " f. '5- -P 4 41,5'878 59 7 . .Q,5--- • . 94t- fo-w-a-1:- 5 ' I !o. • a.5" . 4, 9 z . o -1-52, et/ 6 9) 7o78' l d, 3-© 0 is . 7 . 9/7 Y6,? 3 / 6,2.0 /,- / / A,"-6 ,.,.,, 4, 8 9 17913 5e2 y a.S'" / r a.V (ev-eA.PA/rl 9 • 185'7 6 • 5R 3 a.s- /, a , S.A , Cot-,r--- 10 / 9,10 C, l ac, 3 -C7 L. / h''' SA c.,a-cT 11 . 9/ 9607 Li 01 ' a. 0 . 99 -ii t / �itoa. 12 I,aO/ 8 '-( !� 77 A+5 /w/ fo• 216 . (, r(.' ‘. 13 g z 0 7 i 3. 5-7-61 • 1 c? I . Z.ce ,Q;t ea.. glag. 14 97 \ Z10 • 55.' Z o I , 36 Cut er G."& 15 Z i 3 S/ 4. Sd Z.c ! • Z r: 14ALZ t6 ehlaao7 y4o9 02.0 1.07 . C 17 9a 14083 J7‘ • a2-s- /•// .4,i > „ 7 i 18 c1 3aI1 5C8 02 PS /.Oa �' - " 19 9a.37!oCo 555 3,o 0.95 ,3. / • ZJ- -1- 20 9'2 257 1G'i"' 'Zr 5'. 1 f_/ iu44 21 al Zi/78) ..S 32 ZEv 1i11-- C'o04A " cC 22 e 5 3 .3 Co 55 3 ar 5 I, o I Tom- .?`lee 1' 23 9oi 5815 1-j77 2.o . qL 5,A, -2(1- 2.4 ei .6.398 583 a- 5 1. 6 ('ove; fork 25 9 qa 7 ca.9 .. - 5- /. 06 5,4, d-t- 26 9 .7Ljg3 5551 Gr5 1, 08 13 27 ca„.7768 4183 c2.O f1. O 95 28 908 /6, 5 a8 <2.6- f e / 1 /_:!Z Z /_" 29 9a-901oy 548 a, s l aO � z-P cT Sal 6. - r0 I, 444.. 31 9310/39 I*o!/ 3. a I. 03 5, ' , 66c- -- Copy to be sent track each month to: Minnesota Department of Health, Public Water Supply Unit, P.O. Box 64975, St. Paul, Minnesota 55164-0975 P xE-ovals-oz 15 ,� . ,° z a IC 140-0013 �" 16. 352. I MINNESOTA DEPARTMENT OF HEALTH Section of Water Supply See instructions on reverse side to complete form. • and Well Management pws to s Month of Fluoridation Monthly Report • ,94,, C 7 Name of Facility Street • City County Zp Code 9 n Title Phone a rt-6-"tom )0,771/2/,'7:1-2/2/7/1-1.4--7L, / V 3 7-qL/3 9 �� m Water Source Fluoride Chemical Used Raw Water Fluoride Concentration 7-el- t et-ee— /Z _..._-- g„ . 7013. 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/1) System 1 2 3 4 . 5 . 1 2 • 3 4 5 6 7 . • 8 • 9 10 11 12 13 • 14 • • 15 • 16 17 • • 18 19 _ 20 21 22 23 24 25 26 • 27 28 29 30 • C 31 7013414, OC �? , 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 IC 140-0013