Section
2.
Sample
Collection
Information
Section
3.
Sample
Process
Dates,
Times,
and
Temperatures
Section
4.
Number
of
Positive
Wells
and
Calculations
Section
5.
Comments
1Ground
water
under
the
direct
influence
of
surface
water
RESULTS
Total
coliforms
E.
coli
E.
coli
per
100
mL
Total
coliforms
per
100
mL
Number
of
positive
wells
Number
of
positive
wells
Analyst
initials
Sample
volume
analyzed
(
mL)
Long­
Term
2
Enhanced
Surface
Water
Treatment
Rule
Source
Water
Monitoring
Method
Type:
ONPG­
MUG,
51­
well
Analytical
Method
Number:
SM
9223
(
Colilert
®
and
Colilert­
18
®
)

Laboratory
ID:

Date:
Date:

Time:
Time:

Temperature
(
oC):
Section
1.
Laboratory
Identification
Information
Laboratory
name:

Sample
ID
(
optional):

Sample
collection
point
ID:
Sample
collection
date:

PWS
ID:
Sample
collection
time:

PWS
facility
ID:
Holding
time:

Time:
Turbidity
result
(
NTU):

Incubation
start
Additional
incubation
start
Temperature
(
oC):
Source
water
type
(
circle
one):
Flowing
stream
(
FS)
Reservoir/
lake
(
RL)
1GWUDI­
FS
1GWUDI­
RL
Analytical
method
number
(
circle
one):
SM
9223
Colilert
SM
9223
Colilert­
18
Temperature
(
oC):
Temperature
(
oC):

Incubation
end
Additional
incubation
end
Date:
Date:

Time:

Draft
June
2003
