Section
2.
Sample
Collection
Information
Section
3.
Sample
Process
Dates,
Times,
and
Temperatures
Section
4.
Number
of
Positive
Tubes
Section
5.
Calculations
10.0
mL
1.0
mL
0.1
mL
0.01
mL
0.001
mL
Total
coliforms
E.
coli
Section
6.
Comments
1Ground
water
under
the
direct
influence
of
surface
water
RESULTS
E.
coli
Combination
of
positives
Most
probable
number
Organisms
per
100
mL
Total
coliforms
Long­
Term
2
Enhanced
Surface
Water
Treatment
Rule
Source
Water
Monitoring
Method
Type:
15­
Tube
MPN
Analytical
Method
Number:
SM
9223
(
Colilert
®
and
Colilert­
18
®
)

Incubation
start
Incubation
end
Date:
Additional
incubation
start
Additional
incubation
end
Sample
collection
date:

Turbidity
result
(
NTU):
Section
1.
Laboratory
Identification
Information
Laboratory
name:

Date:

Temperature
(
oC):
Time:
Date:

Time:

Temperature
(
oC):
Laboratory
ID:

Sample
ID
(
optional):

PWS
ID:

PWS
facility
ID:

Sample
collection
point
ID:
Holding
time:
Sample
collection
time:

Date:

Time:

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
Time:

Temperature
(
oC):

Draft
June
2003
