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07/19/2005 09:38 FAX 7634419176
WATER LABS & ECO SYSTEMS
141001
0); -u\
333 East Main Street
P.O. Box 388
Elk River, MN 55330
Phone: 763-441-7509
Fax: 763-441-9176
FRANKLIN AVE.
FILE#
05G-345
PRIOR LAKE
MN
ORDERED BY: NORTHWEST ASPHALT
SAMPLED BY: DAN-NORTHWEST ASPHALT
DATE SAMPLED: 7/1512005
TIME SAMPLED: 11 :00 AM
DATE IN LAB: 7118/2005
NAME OF TEST
RESULT
NEGATIVE
NAME OF TEST
RESULT
NEGATIVE
#1
#2
NOTES: COLIFORM BACTERIA TESTED ONLY. THE SAMPLE PASSED.
SIGNATURE ~ ~
DATE COMPLETED: 7/1912005
AMOUNT BILLED: $30.00
AMOUNT PAID:
DATE PAID:
TEMPERATURE:
>4 deg C
Mill CERTIFICATION #027-141-110
07/19/2005 09:38 FAX 7634419176
WATER LABS & ECO SYSTEMS
141002
333 East Main Street
P.O. Box 388
Elk River, MN 55330
Phone: 763-441-7509
Fax: 763-441-9176
Last Name: BLUE DORN AVE.
Order Date:
7/1812005
First Name:
File#:
05G"34S
Address:
Unique Well #:
City:
PRIOR LAKE
Drillers #:
State:
MN
Zip Code:
County:
Legal:
Ordered By:
Sampled By:
NORTHWEST ASPHALT
Sampled From:
DAN-NORTHWEST ASPHALT
Date Sampled: 7/1512005
Reason For Test: COLIFORM BACTERIA
Time Sampled: 2:00 PM
Sample Temp: :>4 deg C
Nitrate
REQUIRED RESULTS
Negative
Less than 10.0 ppm
Less than 0.015 mg/L
TEST RESULTS
TEST PERFORMED
Coliform Bacteria
NEGATIVE
N/R
Lead
Not Requested
This sample DOES
meet the State of Minnesota and EPA guidlines for safe drinking water.
The test results are only indicative of the sample tested from the sample point on the date collected.
Water Laboratories, Inc. is certified by the State of Minnesota under the Safe Drinking Water Program.
Lab 10# 027-141-110
Water Laboratories, Inc.
By: ~iW~
Date: 7/1912005
Amount Billed:
Date Paid:
Amount Paid:
$15.00