l/7t A 17

,-------1 'fCJEQ Microbial Reporting f' orm

-, TCEQ Form 10525

I OW.017 Waler Syslem ldentificalion & Sample Collection Information (Please type or use block print)

Public Water System ID: I TX I 2400001

1,.i.,..\oc,l,..r-,-lr.onckO:.:<-,'.)Jl:('1t1,)

Public \1/aler System JEFFERSON WATER TREATMENT PLAN Name:

Councy: WEBB

Nzme: AN�6N �/�)

3 Address: 5816 DAUGHERTY AVE.

� a: Cily: LAREDO t: � cc. Siaie. TEXAS Zip Code: 78044

Phone#: 956-721-2000 Olher Ccnlact 956-324-8626

Sam1A�r Name (Prinl): Si�cL-

SAUL CARDONA

Oi,trmo, license::: □o·,m•r WD0014734 p Operator 0th•r: INSPECTOR

;:.,i,o�(\1c' ,,-.,.:/;n,,u:J.-rp,yr.1 "'-�1wJitt.'.).T.;.:r-:u ., ,wrc (NI".,:,•�:;, c:,.·:ci :Jo!!.r .,-,:.;,.,.· .'(�JIIJ·,.._ lic•�:f',n:;Jf;:.U. Tlk. 4 Ctu11:t· J7. •a.i Bt ,,;r..r.1 Ut:J :�n. t,�tt t•�•r <Y�V,.• l::'f�� � ,.>7;-,\-, ,.-�.t c.o.;«fc:.f ,l�l�Jt.: fl..; .:fl!t•l\lC.:.fJ:.)Jr,:: !"J�\.'<�l'(O�:f�'U. 4-"',,t1'a: ,-.,-,��U J!u..",J.;c

San\pla (dentific;;,tioon.oc.,,(fon S,n,plo1ypo: (•,'0110) Coltect&c.t S2,pplc ID � Dall: ol Us\; Spc:c1ftc Address/ location identified In Sample 'c- O-,tc Timo Drigi,,V-ogS.:,'1)1•

S1tine. Pl.lo j ·ti J(MR,p,,al

$ 5 ,_ ;; PJc;,se circle Rci)l�cemc,11, & �� .,. � .s C 0 ., TITQ:1e1cd Ra,,. 11.w, Wells • lhc Source 10 fo, Well S11mvlcd l£lC,,1op\c: � 5 � g 0 f) AM or PM -li � :;;_ >-GJ2345G7M

& � � � s,mp1.s1 rr 9. tr. a: to

/ lo 7 /t·J /.:).L. I�/ It> 1 I� l/1/s-�

cr:, .. ..._ .... ,a.-"-".�:

(§1 Public a:ea..1 th 1�_.,...,.,,,t�ll\.,\• 1•,·,••t•

Citv of Laredo Health Dcpartrnenc '-�ou,-acory Environmental .Section

,6CO Cedar Ave. Laredo. T)( 780�0

(956) 795-49011 • 4693

or� .. �,-:i:,1�;�

Tl04704368

TCEO L•�oratory ID:

rcu Ucsvlu muJc meet ol/ o«rcdi101,cm /cc,1i/,'co,:o" 1t(ju1rcml'11U tmlcJJ Jto!rcJ 01/icr,.,,sr. 48014

,. SHADED AREA FOR LABORATORY USE ONLY Samplo lcod7

Rc�rc:T�� _J J'1 r. D•�;;;ft9 � Yes 1□1 No (_',;2 C/p.,......_

l'h�!!i-:00 6)· tCo;,i.c,. it .l��n?>lc): Dale I Timi Tcmpe.raturc

iO ·l0

oc ��·?�"'"· Oiliiel Time: /4

ro/7 ;--<:; t �.,1 p Ccncc:ttJ1c.11p R<..-,,,:��

o,�Fr7,q i; .' ;i_ "8 {) ti-\Lob CG-Jnrneols. tncubJ\iori Date & Tlrno /

Beoln I Enu 1

TestedOf ';1/.

Oa:r.: IO/t/ IG l?a!a: / I.I ,y -I'

&uo Time:·r� 1!)1"'\�le. ; : s-o � Laoor

�pp,�·

c?A�Lc-v D�le: I lime.

-

'I,) �_..(I._; V. 10- <t'-/c., t,: <;;'Op Repo<:)6Cl:cn: 8y: Dal�. Tir.1r.·

Chlorino Rc,iduol Lab Results Rojetlion COile Test

1Cmq JV , .1/Cite.le ·p for Free. Iii ap,foablel

T rorlo1al Plr.asc

Re�bmi1 (mgll,)

,j. 1.5 .,.£.. T

�-7 l.f

Meu,otJ: ;\_�_ ">i - i/ Chlorine,, Total Coliform ECo/i

Absent Preson1 Ab�nt Pio.sent Absenl Ptesent

0 □ lZI □ 10 □

li2f □ � □ r;z1. o·

Laborato1y Sample 10 Number

I !JO 1 I CJo 15 }DD 111 o,G

/ lo 7 h ,tl.'15 30>

IJ.J' � [ul D lul □ g' □ J 0 o ·1 I °I 01"�

ii"'\

�

47 i f!) 71 4 'l �

j/ /6 1 If ;).} !i/ � 19 � T � □ � D 0 □ /O\J1! q () lJD

14 g /

A SJ

A1?�

14-t f 11

11 r.s I

_,,'/ (o _..v

fr.> / (o

I./ lil) I" /o

/ lo Fotm ii1Jlt\JctNn:.: w-,-w.1coq.Jexas.9u11i�rl11king,rote1l1niclooi;Jlltv>ns•t1-1olnf,e,{ilorm-tvfo

7 '?

7

7

17 7

If IJ.'>7 "" ;;.<; � '21 □ v1 □ ri2i □ tbD1J 9 Dlv

17.:: T

/7 2�() � 12.10 � 12( □ 0 □ 0 D /0D11 Gi O_'aj ""' It ').'S/ � :).. /(/ I& \21 □ '21 □ Ql D J ,� 1)1 f Cj O fl IT

Cf.'»- '* :; Yc2 �- CZl D liZl D � □ I (') ·1)11 9 oi;r-11 T

(� .t;".70 � -0 ill IZ) □ � □ -10 I o· ·,oo71qo<J--< T

I'( �:r;. � ;;,� ( __,., [Zl D lu! □ [E' D I 0 1)7/°J0</4

• Sp<-cl.i ond Conlruciion ssmp� "'" NOT FOR CO/.f PUNJCE Lab Rejecled Code (LR)· Ooa,m,nl Reason:

Gio· G 0-+(,0 (2,

9 C, to

c�·1 C1·:y

0

I

TCEQ Microbial Reporting Form TCEQ Form 1D525

08/2017

Waler System Identification & Sample Collection Information (Please type or use block print) Public Water System ID:

I TX 2400001(t.tusl be 7 d1911S: 1nCIUCO all /Ct'O\)

Public Water System Name: JEFFERSON WATER TREATMENT PLANT

County: WEBB __ ,b JI);- rJ�t;Name: ��

0 )Ju�� \l....\ os

� Address: 5816 DAUGHERTY AVE a: City: LAREDO ,:: 0 C. "'

State: TEXAS a: Zip Code: 78044 "'

Phone#: 956-721-2000 Other Contact: �56-282-9520 Sampler Name (Pnnt): Signature:

)� �JOSE LUIS GARCIA

Operator License #: WO0044484 Downer l=fapera�lother:d. Inspector FJ1s6:J:on of tt.1s f:rm or tJrrpeMg l\,:n "J!t'I' .s.11np1Ci ,, J Ctlm(' puridM�� un*r .state .:,,,d'ot lrdetiJ/ lll'I, (Tt1JJ Ptn,11 Code. Title 8. Chapter 31.10) By s9tl.111 this lomt. tile- sa,r,p,lfr aw,o��s lhlt SMJP-'ts -''tie co'Jttt�d «cordng ratt>t sylttms cst:tb�slr.d s�c�tdion f)IOUdr.tres. and Ptlr 41.wtrna.tion,s .Y.cura:c

Samplo ldonllncatlon/Locatlon Sampfo Typo : (-Jono) Colfocted Sample ID & Dato of Use Specific Address/ Location identified In Sample Dato Time Origlnaling Sample

Sitinp, Plan C � l (Alf Repeat.

0

i n ,: Replacement. &

g� "' � � c >- io Please circle :'l 0

,., ., Triggered Raw Raw Wells • Use Source ID for Well Sampled (Example: - ·s ., 0 AM or PM iB � C. i ! " ::; >-., 0 Samples) Gl2J456711) a: 0 a: a: u a:

./ \C 1 e:, I . °5 5; am

7'

v ,� l- 9 2·:32,.. om

�

J \(.) 7- '1 3' 0'=, am

�

J lo ,. <, ff3b .,,,

� J l c 1- '1 't '.Lr;

am

;,;,;;-' J \Q +- C, ··1'·'-1 \)

am

? •m pm ,m pm •m

I-pm am pm

Qty ol a.u.dol&..ah �t

����

@Citv of Laredo Health Department .;;boratory Environmental Section r' ( 26CO Cedar Ave. I

Laredo, TX 78040 *<111

Public Health (956) 795-4908 X 4693 T104704368 i•,.,�.,nl. l"hHll••I" l'lul .. .cl TCEQ Laboratory ID:

Test Results musr meet all nccrcdirotion I cc-rti{ication requirements 11nltss stated otherwise. 48014

SHADED AREA FOR LABORATORY USE ONLY S;imole Iced? Rclmquish<d By (SamplCf):

� Yes □ No , \ei�E- li...,,':) l� "'l'\.t.1,..

Date /Tome: J e ·:; b l' H \ o/:t 1q I: .

Recerled By (Courier. if appbcable): Dale /Time: Temperature

s,/ oc

Rclin'll!ishcd By (Courier)· !/• / V,_ "---j . L . .£-, :/ 1/

Dale/Ti/ / \() -:,- ,ei

e_ _s-:�-oP•, Corrected Temp \

;__/

y

r/_"�

_,

Lab Comments: -

Tested By:

•- ....---.... II Laboratory Approval� M�/Li,,Report to Cf.en! By:

Chlorine Residual Lab Results

Date;O/) /Oi e �-sz>L,<__:;Incubation Dalo & Time

Beqln, Date: I rn 1 11 q rime: 6' 00"'1\ Dale: I

End Dato: IOI 'I,( /7 Time: /,, _'{){p ofY'-Timo: I

/6 -f"-te:J 6 ia(p 1A J Date: nme:

Rejection Code M:t��d: 13)1( q;»o D6tlCircle 'F" for Free. (if applicable)•

Please Tfor Tolat. Chlorine ,J Total Coliform E.Co/1

(mg/L) Resubmit

Laboratory Sample ID Absent Present Absent Present Absenl Present Number

1�\3 L [lJ' □ D' □ cr □ /f901l9 OS fT

3-'-{ � g □ p- □ 10' □ 1001/90& 0T ,

3.3 6 u( □ (k;( □ l!1 □ /001/0J o�/T

2.. <=\ fil Gt □ 10' □ lj2f □ /f7o1! 9 ot. ::J.T

3,1' _ID_ � □ 10' □ 10' □ /0D?(9 (!}fr;3T

3.4 � g' □ 0 □ a;r □ I DrJ 119 0l If T ....!:... □ □ □ □ □ □ T ....!:... □ □ □ □ □ □ T

F □ □ □ □ □ □ T

....£.. □ □ □ □ □ □ T Form instroclions: 1w1w.lceq.loxas.gov/drinkingwatorlmietobiaVrovised-lola/-colilom1-role ' Special and Conlroclion samples are NOT FOR COMPLIANCE lab Rejected Codo (LR) • Document Reason:

.• ·-..

TCEQ Microbial Reporting Form TCEQ Fom, 1llS2S =

Water Syslcm �llritali011 & Samplt Calledion lnmm!alion (Please typo or use block print} Public Water System 10: I TI(,i: 2400001,vwto700h,.""""""'r4�

PublicWaterSysll:m '

Name: City of Laredo Utilities County: Webb ":!·

Name: Juan Rios .{i. .. Address: 5816 Daugherty Ave i a= City: Laredo

11 State: Tx ZipCoc!e: 78041

Ph:>nei;; 956-721-2000 O:herC011tir:t: · 956-721-2007Samp:etN.we (Pm!): s

zgz-

R. Estrada

Opcra:cr!Ja!nse�W00043965 bermer P OP=!Or Olha': Samolerc., -: .. =♦:;:cc'�..sL-=v�-...,.,!">a¥t"�;s:�C"":'t�'#tv-!,�,.�,..!c=c:tl!lc. ,,irJJJf("ll:Q_"(. ,, .. �I.Cr..z:<1'�; :os,,.•:v-:,:r--t!:"'r: �� !:&""':•·�:::i:-.s::-:-:���n:::::-:.-r--,0�,..:r-.:t.��_.;..-�o:-e:-,,:.��r.::1.,:""-"'o:,..,�

Sample taonUflQ!lon/1.0calion S;unpto Type: ('< OIIO) COllocled S:,,:,:,:�IOC.D�� u� Soccific Addr<nS / Lo cat ton ldcntffiec! In S.,mple D�tc T.m� <:,;p,:,: .. ,s,,,;:.

Sltini: Pion I .§ I �= :i I

i• 2 ,. ... .. �-- �&

now \Vdt.• Usc Sourc.-10 Cot Wcll 5.>mp(od (Dcamplo: � - j ., � N.lorPAf i

T,w:ralllaff i ! ""

0

Gll34SG7A) �g a: a: S:rnplos)

}/', ·'":l iC/ 11:1) �) I i I 13:� �

. ) \ \ l:tb· ¾i l:J..O � i I �.ZS-ti ) �;3S -i ) [).'.�S-¼ ) ':?,· l'\/1 �) 3,:1S-

..

.-\ l :.r {V ·s.3S r.i-

Ol:r4 ...... .--.�

@UN o! Laredo Heallh Ccp�rtmcn,

a ..::�or�tory Environmcnt:>1 Section

��2SCO Cedar Ave. La redo, 1Y. 78040

PuhlicHcclth (9S6) 795-4908 x 4693 T10470436i ----- ... _ .... ,., ........ TCEQ L:lbor.itory!D:

T,uRt'w/umwmccfallaamlilDlitJn/cr,t,{/CfJ!io,ircqufrcm<flUunlrss1101tdotbt,..,,se 48014

sHAo;o AREA FOR LABORATORY USE OlllY S>mal� !cod? �,c: ():itci,,'ltr.e:

�YG$ D No f(.� lo-1-19 J':.Jcf �M,

�:,:.de-, (Co,nt,, I �..::tier. ��;T"1'.o/. - Tcmpcnllllr� /

<ii. L{ ·c �02 _) 0.,ldT� /0- ,J7 i;-:�r-1'\.

=:e<!TCll'O lha,·�t J/ h ,A I J./ IA, ./ o,i,,m:ne: i/ , / 10 '.} I q <-/ :vf:,(J(H,,

�j "

�B! �h

'---._";§ �.�A,J,, Repolt!o�n:By:

Chlorine Rtsldunl

I � lncub21ion Dalo & T,mo Bcqio / t Eruf /

Da!e: �Of//,/ 7 IOc!o: //I/tr//., r.i:�: � .d ..LJ.run;;: //, ·�,f..__,

/tJM"'J D>le'...::.6.3., .AT,mc:J '

t,, Oalc: I TIIIIC:

!.:lb Results �Cc.!;!

111::d: l') fJ14 .)a-� J:Db!, � 'P «<Free. (ila:,;:(,C;I�-

-rrcr10:::1. f'!ea5e Chlorine 'i Tota!Col�om, E. Coli Rcsubm'l(mg,t] Laboratory Sam;,lc ID Absenl Prescnl Ab$enl Pr=l Abstnt P=nl

rlumbcr

·s.ao .0.... C!( □ rY' □ .CB"' □ loo7I Gnn1T

-:z� � C9" □ a' □ 0 □ l o0'1-/ q6oY

�,tv) 4 DY D IB" □ 0" □ 106119065 JJ �j

.£ [;J" D IJYi □ � □ 10011 qoo� T

hfS L£ [jJ" D n:r, □ li3"' □ 16 o t I qoo 1' T

.9,B jlL IZl:' □ llr' D I;¥' □ ; oo 7 / qoo'6 T

J.� � [9' D � □ ar □ l O () 7 I Cf f\()Ci�.IS- � Ef □ or □ 10" □ L06,, q 610 T

9,r;51 £ � D 10' □ lid' □ 1 o 0,1 er al/ T

.(,�t c.sL [3' □ Q-" □ Et □ '/00 7- 0/0/;_ T Fem� �.tceo��� • S)>Gtial :m��.wHrJTFOR COIJP1JANC5 Lab Rtjed,cd Ca1e Ml· Doa,a'l(r\l Rtason:

TCEQ Microbial Reporting Form TCEO Form 10S25

ca,�,J

Water System Identification & Sample Collection Information (eJcase type or use block print) Public Water System ID: I TX. JC/oono I(!.'..,..: bf, 7 41j,<11'. 1ncfl.O.) ;'Cl /dO-.)

Public Water System I 1.-l-;\i-tie.S Name: Li0 /J+ /_r, -{'° Jo

( County: \JJe,bb

Name: Al'\ .1,,...,n ,·o (Y\.C,rc ... � Address: <;-5< IL Dc.-.1,,.1. t +-v AV��...

Lc,y-.,.- Jo J (

City: t:: 0 a.

7'6' 6 '-f \State: T·-f.-.. ZipCo�e:

Phone;;: � 5� --7:J (- )oco Other Contact: 9� - ?J \- Joo 7 ( Sampler Name (Prin:): Sigr.ature:

V 1lioY ') c.-1 IV\.fJ.A.. � ,d��;;)z_ S, OperalorLicens

�:J /) !Ni\ o,3'GJ CS'

Downer p Operator 0-.her:s; yv1p/

e, 7'"c�•�,1:ci,o!t"'.a:tn::cr!JT";c,.:-:.1 �Ji "6'<""SJ1':.tsd.>C'\":"t�-:s.'\J:i,;,ur.:e- u.1:to1r.::.«:,cr.:J:J•. {Tts..J>Pi"'WC,,;:ct,. i,:c r. ��:,:,·Ji JC'JS,�,-�:Jt-s.hr.-.. ::-.e :.,� uelrc1..-ft<r;:; t'U!.!J"l'l�t� .. e:: CG,��c$ ,:co-:f ,9 tJ ::-� s1s:c..:i: u!J!: V:-::1 :.l"r�"t cott"'.l« ;r...(.e,�ns u.:ra: i·r.';;":"'".J:c, •J �c

Sample ldontifieation/loc.>tion Sample Type : Nono)

Use Specific Address/ location identified in S.ampfc

Sitinr. PIJn s ,§ (.I ·� �

1 s

.!: :s -;;

1 R.w, Wells• Use Source ID for Well Sampled (Eumple: C, 3: i!., a.

Gl234S67AI a: '2 &: .. ts-a:

X ,, X

1-·

X. :1..

'

Ix.

Date

£ >-" .. 0 0

lo 1. ID '). JC 1 le 1c

lo 11, IC�-

Collected

Tome

,., Ptease cicle ., :,. AAforP,' • .f

,q l :os-� l'i 1.n' �

/q 1·,5C �I'\ �'.IC\ � M 11',it �

� l� :>:,,_,, -� � � �

Szr..;:c 10 & Da:o � Cng,rot,:; S,,:p:e

I v-1Re:>e3C Rcpla<c""-"'� &

i Tr.ggcrcd Ra-1t

�es) a:

D

CJ0'4----��

�

<.,tv of Laredo Health Depanment

·8i..A:>oratory Environmental Sectio:i

26CO Cedar Ave. Laredo. lX 780�0

PublicHealth (956) 795•4908 X 4693 Tl04704368 , ........... , ,., ...... , .. r, .. ,,..,., TCEQ Laboratory ID:

Tnr Rt:sulu must meet au occrcditorion / ccn1/Kott0n rrq1.111cmrnrs unlns srored othcnvisc. 48014

SHADED AREA FOR LABORATORY USE ONLY S3111blclced? Re:a:w.s.� Bv 1Sa,rplcr) 0a,�1,imc:

rnrYes ,□, No v,-;ik,,r sJ,14t..'I 1cr7-t "t 4 -V -0 \D-1-ti

� P-vvt R!:<i,ed 6y (Co-,-..r. t a,;,l:able/ Da!e/T1me:

Tcmp<>r.iluro

t-1 Re:it:quishcd By (Counor) '== Oa!e/T ime:_., Of" /] IA , }D=91.'1 - '(-:l4j - --.,cu

Cotrc::od T CIT() \ �cuNoal� D?e,Ti_:e: /f;Jrfi_ 7-t'? e.

LabC::::er�

TeS!�// �.J-;,; �:ortJdP� �J. Report toCtcnl By:

Chlorine Residual Rejection Code

Circle·;:· tor Free. (� a;,;,l:wilej •T lorTo:al. Please

Resubnit(mg.'\.)

a.qi �T

I .i� �T

'J ,l{ � 'T

3,5 �T

f),q 8' �-T

o.9<o LC!2T•

...£... T ...£... T

F T F T

Incubation Date & Time Beain J End /

Da:e:/,1/7/C7 Dale://j/ d7 / 9 rrme: �� Time: _,/,•::1.L

/()/t/45 Da15

Time: I

- J...-,2) /· Dale: I Time:

Lab Results

Test JVw � -p__). R. , Method=-.. ) � ...,... c,, '-T 7\ Chlorine.; T Olaf Colifonn I

Absenl Present Absent Present

0 □ � □

&Y □ 621'1 □

[:( □ ur.'. □

I!::!', □ lid"' □

[!I □ O" □

g □ Gr" □

D, □ D □

□ □ □ □

□ □ □ □

□ □ □ □

E. Coli

Absent Presenl

m" □

� □

u?' □

� □

I;;]! □

CB" □

□ □

□ □

□ □

D □

Laboratory Sample ID Number

\(51)l / '1ol3 i o7J1 l Cfol Yl(J!J1' I q D I ) '°

o or/ 101 <oI DOt I Cj on--

I ri (), I q () \ i

Fonn illstrvclion5: w.1-w.tceq.tcxas.govldtinnngNalcrlm--aobi.JVtTMscd-t�onn-wtc • Spcoal and Contruct.:,n samp:es are NOT 1'-0R COl.fPUANCE Lab Rejeeled Code (LR) • Documcnl Reason:

l)

r;XtJ I

TCEQ Microbial Reporting Form TCEQ Form 10525

0812017

Water System Identification & Sample Collection Information (Please type or use block print)

Public Water System ID. I TX .Z...40000 l (""'usl be 7 d g1ls, indudc all 1ercs)

Public Water System

GM YD t)Name: C \ -C\{ ot:: County:

w�e.

Name Jv-ll\N R,\ 0 s.0 .... :!!! Address �f?I (, --cA v-.t; 1-{&R, T'( Arv c; ::,

c,ty L��o. t

"' State ;+ ?}-o 4 l 0:::

-rxZip Code:

Phone#. C9�f:i) � vt.-?/400 Other Contact

Sa'Tlolc· '-Jare (Pr nt) Sg

� 'S \-\ G- w C 'rt \ I') Ii\ \... � t-f\ ( Ope·ator ccnsc II

Wd4<f4\'16G Downer �Operator Other.

r als,ficabon al ttrs fam 0t lampcnng N"/n watCf samplos ,s a Clim� puntshable undet sta/o arn:Vor fccJc,al law (Tc.r.as PvnaJ Coda. t,tle 8. Chapter 3110} Ot SJgnmg lhs farm. tlro sampler

acktY.r,.,Jcdgcs that samples wcro colloc/cd accord,ng to /he syslcms estabhhod sample collcct,on procedures, and that al ,nfom,a!;on 1s accurate

Sample Identification/Location Sample Type (,/one) Collected Sample ID & Dalo ol Use Spcc,fic llddress / I ocat,on identified in Sample Date rime Ong nal sg Sample

C: (All Rooeal . Sitinp, Plan C . Q C

0 t; �� Q) .;;

i 5 >- :. Please ctrcle n

Hoplacomcnt, & <ii s: C: Raw Wcl.s Use Sou"ce 10 for Well Sa-no ed (Example 0 0 "' '" r nggcrcd RaM

:j � � f5 � ::. 0 >- AM or PM " G173'-5671\) cf.CJ "' 0 � Samolos) CY. 0:: U) 0

J /() ":} 1q tf.' 15 am

� ✓ /0 -;}- \ 0, :].'"35°"

am

� ✓ (J � ( C\ �· /cJ � ./ '" � (q &'.� � ✓ ;f (9 ).•S(} am

/0 � ""' ✓ {O ;/- I ci '.) . ,-, J ,_.') �

J 10 ::r- (q s: /0 am

� I (<> ;;,- ('J /3:3S � ...

1--pm

am -pm

TCEQ Laboratory ID:

Tes( Uesults must meet all accred,tor,on / cert1/1catron requirements unless stated O(herw,se.

SHADED AREA FOR LABORATORY USE ONLY ,

s..rnole Iced? rMnqu,shod Dy (Sa•nplor)

E1f Yes □ No sHG\i\J L-V)"1\Reco,vcd lly (Co,,r,or, ,I appl coble)

Temperature

o/-�c Rel,nqu shod By (Couno

./�- ;J

Corroctcd Temp � J(f;,A� ,/

Lab Comments: -

Tested By: If:-:., /) I v1vl

Laoor3J/rl.ro;;/4.#!J

/t) (v - _.J_ . - -<f--;q

Repott to Client By:

Chlorine Residual Lab Results

-Date/ l,me ( b l'.:f-{t� T $,(, 4,'. P·M

Date I r,mc

Date/ r,m{ ! \ D it"° \'\ 4 : �0 'P'"""

voli1A/J tG j

./,;r1£J( lncuba{fon Date & Time f

Beqin Erul , _ Date:/O/?/l':l, Date: Jq'O fl/ Time: t./_',:, C, Time: ,st'��

�c-p,_) Time:

Date: I Time;

Rejection Code

C,rclo T '.or f roe, (if applicable) Please

Tosi hi � Method; Ji/'tJd-,,., 'lt:1(

"I" for lotal. Chlorine v Total Coliform E. Coli Resubmit (mg/L) Laboratory Sample ID

Absent Present Absent Presenl Absent Present Number

,yo I;) � □ � □ � □ 1007/90/9 I, 31 rm

<)., 1� S" □ rn" □ � □ 10 D 710;() 6J.,0a., 7

".>,'1 (j) 13' □ cg' □ 10'" □ 1on�11D:J I:3.8 tJ 3,4 "'3. 7 �� Gr □ [Y □ (g"' □ II}/) 1/q O ;;J,_d ?-� -� �;)

I� � □ ®' □ cg"' □ 10 01/qo ;J. 3 ft , I � Gr □ [!(' □ Gr □ I /J 11 1 I 9 /] ri.. l 5. o

4 J. ,-� 13' □ B' □ Gt □ I I) l) rj / Cj U d- �. ';;l j W- ITi □ � □ O" □ JtJ()

r//tqO:;)_

I

.2.' I I) ,;(. •. F

□ □ □ □ □ □ -T

F □ □ □ □ □ □ r

Form instrudions: www.tceq.fexas.gov!drinkingwaterlmicrobiaVrevised-total-coliform-111/e • Special and Contrudion samples are NOT FOR COMPLIANCE Lab Rejecled Code (LR) · Document Reason:

TCEQ Microbial Reporting Form TCEQ Farm 10525

OS.'2017

Water System Identification & Sample Collection Information (Please type or use block print) Public Water System ID.

I TX 2400001 11.•1111 tit: 7 d") I� •ndUC(I �·1 ,crot)

Public Water System Name: JEFFERSON WATER TREATMENT PLANT

County: WEBB

Name: ANGEL LEON 0

5816 DAUGHERTY AVE. 2 Address:

0:: Cny: LAREDO t:

"' 0:: Stale: TEXAS

Pnonc #: 956-721-2000 Sampler Name iPrnt)

SANTIAGO MOTA Opera'.o,l,cense�

WD0014297

Zip Code: 78044

Other Contact: 956-33 7-0083Signatu•e

Downer p Operator Other: INSP r,rskJ'<¥1of t'li, :'J'"nt' lil"'ot·r,11, �.,,J· 111•�• wrrpl(Js11, .lC'•'N nv"'mJ.�e f,:f;J(>' !Ja:11,1.•,r.:n:l«14Y�'UW (i,Y1• f'i•"-t'C(yj{' T:!? R r.:-.ipu,r 37 J�)Bf SJ9r.�tt..s tom, me urt·�· i..�,v,11"�.s 1t,.J' sJ.'T'lp'cs �·,.,e ro-"«lcJarc�J•�) totJ,c 5�s:r':'l� fSt1f>'1i':rd ,amp!� coi:f!rQ!'I CttX"C<l!.,,s.. :m:t r11.,t 1t.lf111'c'l"'IJt:o., 1, «cum�

Sampto ldonlificallon/Locallon U!>.e c;pecific Addrc'i� / location 1dcnHflcd 1n Sample

Siting PliJn

R<h'i \'/('It,. Uw Stiwc,• ID fn: Wra S.-imolt•d (f ic,1m11ll' Gll34�b7,\I

'

Sampto Typo (� ono)

� gli

i � " � l i� i � :§ "'

er.: e. a'. 0:: u v

V v

V V

vv

1.,--i--

V V

v" I✓,V

V

Collcctod 0:tte Time

� .t:: ,._ ;;; Plcaso circle c

� 8 " <> -:;; 0 >- AM er PAI i"' , () 7 �� 1:30

om

�/0 1 �� 1.'ro � ,a 1 'li)f �.'�o( � 10 \7 uF 1,:4;1( � IC 1 ui'i �:¥}, �)

il ? Lo\C 'I, 't1u.

""' �

Iv 7 �(J/' lf·'sb an

�'.)

/<9 7 f].J "'"'

S.oo � (o �\ '<S.'3o

"" f7 �

Jo t IWlf G,;IX . .., �

Sample ID & Date ol Cngi.,atrgS-l��e

(All Reoeal. Reµacemt•nl. S

Tnggcrcd Ra�v Sarrpl.s)

j' �'L_

5-

Ck.y�l..-dle).....,.�\

@Citv of LJredo Health Department .,,;_

'"'

�� c<,otJratory Environmental Sewon tNI 26CO Cedar /\ve.

"Oj� Laredo, TX 78040 Tl04704368

Public Health (9�1(j) 7%-4908 X 4693 1'1"'"'1\1 l'r ,.,,.,, I' •;<* I TCEO Laboratory JO:

T'7st Results t11U,St mc:ci all orcrcrl1tC1Hott I ccrr,j,c,won re,,cnremC'nl'> ufl!C'U stmt:d ocher.\'IH' 48014

SHADED AREA FOR LABORATORY USE ONLY

Sample lcod7

� Yes □

Temperature

3, LI. Conccled Tcnip

L'.lb Commcnl�· .11

Re• rqu,st,ro 61 (S;~p'c•l

No S{luT;fl �cJ rn,.,,-/,A Reter.-e,d B) (CC-.J"l(i�. 1,..a::,;,·�.1ti-eJ

Rc·in,:u;!.hca B:, (Cr.�11Jr}

oc C, O,· 'I- t ;,J -� ·\ {Y/ o-f ,/4 ( Rc�.,,�,(i 1S-,_

'-- .I _A _J

-,,

A

Tev {2_,uri ft. {!__, LaooraW�;,

� Gl,,t/l Rep01116 C!ent By:

Chlorine Residual Lab Results

Oate1T1�1e

fe/7/:1e,'f &, ;oo JW Date Ti-ne

Oa:e/T,mc Jc// /•JA/ ({ � >..lS,,._J

Da��

T7

'J/;

'7 �l ;lo,,/. Incubation Dato & Time

BcoinA End Da,cJlf/ '7/f? Date 1(.,1- 0-t-/Time. / � v'iLJµ T,roo l, ·<nfv,. Da�f: T,me

JtJ-P-11 v: S'D P, Date: Time

Rciect,on Code M:t�1�d: l V/l7 9&?J7i)�k"-, / Circle "F" for F rec. c,r applicable)-

Please ,·ror Toial Chlorine ,J Resubmit (mg'L)

Absent Present /

-J .. n l2.. 10 □ T

�.?_ .s£_ cg' □ T

::l, 2. J!2. l1Zf' □

Ji.IP J!l.. g" □ I

8,.5"' J!;L 12( □T

i.o � ls:t' □

3 .;t__ � Id' □ r

'ad �r

1:1 □

i•• I � [�'.f; □

;:). ,th � r1 □ T

Total Coliform /:. Coli

Ahseot Present Absenl Present

[3 □ � □

10 □ 0 □

li2I □ [jJ' □

Ill □ riZf □

g □ � □

rn' □ 10 □

0 □ [el □

� □ !el □

� □ 0 □ 0 □ � □

Laboratory Sample ID Number

ID O 7 / q Dt!; IOD7l9Dfo4

JDD7!9uG_·1 Joo1r °' Ot� ) DO 1 r C} Db� ,ov1rc,oryI /001/ 9071 ID O 71 9 \)'1?-II OD 119 D 13 /1)01 J 9 O ·74

folm L1stll1d1ons: 1w1w.1ceq.1eras.govtdrinlongw111orlmictobia!lrevised·to/al-c-Ol:foan-ru/e 'Special ar.d Con/ruction samples are NOT FOR COMPUANCE Lal> Rejected Code (LR) • Document Reason

"\...

'>,./

-�

TCEQ Microbial Reporting Form TCEO Fonn 10S25

Water System Identification & Sample Collection Information (Please type or use block print)

l!tv of Laredo Health Department L;.:,ur;itory Environmental Section

26CO Cedar Ave. Public Water System ID: l TX ..!Jil,,.rJ/"VV") / .,,u-.t1x,1c:,o.t-:..1ria..c.,.-.:1,'.f0'\) � V\: T U�

Public Water System Name:

La redo, TX 780�0 PublicHealth (956) 79S-4908 x 4693 no4704368

!---'_ ...

_ .. _, •

_·•·_

·�·_

•·_

•·_"'1_"'_' -----------.J-�TCEQ Laboratory ID: TC'U Rcsulrs mu11 mcC't o/J occu:dirotion / ce111/,co1,on tC'qu;r<'fflC'nrs unlNs srorC'd orhel\viU:. 48014

14.J [A a :;t/oR LABORATORY USE ONLY

1--�-�co_u_�-=-=,_

.,(fi' _

_ ___,l:J"'------------------------1tr.,Y,

=.Js�a�m::.c•P�lc�lc�0::,;[

j?:..:-=__rR;:;;�'";;•tuir.i·�

�;.;;d�;u), �

_1-�,���

�:::---7oDai1e:'i'1��- ;�--::n::--_-

1:-:/.J;;--

c{'_;:-/-;

(-;-;

/J.:;-/1'1.

-:-i

Name: fflV IO /J I O /YlO I</( ULJ I Yes DI N

o loRe:::,.�,,ed::;;-E,2y�(Co.ne�,,=;=_ t'=a,;,1:;=::a:::=lll�•r----bDai7•e.'.:,�t.;:.:m:_� _ __:_

l'__:___:

7'._.:...::._'._-I �.,,- I-

Ad-

dre-

ss:-i--�

-

g

-

(_

0_

1J

..;...

A

.....:..

/A.

_b_

l/i�-/J"(l/_/l_V._L_� ----------+t---L-

_Te-m--;

J

""L-"':-:

-J

tu....1..,-:;-• �

"!ReR=�·- qu,r,ii,·,hc�d '-....B•�·' �y/=-----��-;::;-�--:;;---:-:;;-;::-7U( I , DatelTnnc/11 •• r'l- IC/ 6.r?,<7 DIJ � City: I /J. /'J C' II D

Of' - �-

� { I/ /' I' ( i/0 nvl !1----1--/JT-=.,,...-_/;__;__'{f_\l-U _______ �---�-------------1 Cooc::edTem;, \ ;:::•ivca8J¥'>j /! - State: Zlp C�e: 70 {)L/-( � (ku;..�

1---

--l-�--':o�-------

-+----

-+---,,.-('.J..:_

l

_______ --,.<-l ,

lral'i

: __ �r.ls"i1 / Incubation Dato & Timc

Ph�ne :;: q5:G - 7o< /- ;2.000 Other Contact f'6b- <J. /J/- /JrJ(JI] { Beain • End

1-::-L:--:-:---.!:-:-::-----------L..--,-;::=-::-'='b::.;:::::::::�r'�-F

'__::O'�I ---�� Tes':edB"(,( .' / / A� Da:e:!a, .//£."") Date: J IJ�'y...,/ 1

Sampler Name (Print): Sigr.atute: --........_ --;/"7 � � rime: /.,,,/ .-\IJ Time: / • < 0 /., �

1<ACV\o/J MAC-1 �s - � <�:ory'Jt/""� t..i -; 1 1c/.P/2t; € d,°J�Tune: -

Operator License�: C}J � tJ{J f d,. :;q If Downer p Operator Otheo/Jn/{(if Repo,t lo�nl By:

c�'s,6:.)!cr.dr--..s!:re-;et:.J.'f";.ff.":") ,s,::Jt11,J'f-" s.>-r:;.:ts:s.,��c;;.:..�'lJ:W-ur.�su.:i-.1e·e-:�tJN. fT�1.JJ Pt!'IJ!Cct:r. r� t. C:-..>,:1•Jl 1t;JS11-;•...;,:..,..�::,....,..__ :,,� :.,� v:\rc•!t�; �J! �*' -'t'tt' «,,��d 4':co-:11'19:Jr.--# i;J:c:r.i.;, ts:.J> �:.1 ;.rr.;it COir..:,o.� :r...<t::�rr: .:ir.:: MJ: �1r.!,":':".J:c, ,sr.:.:ir;:c Chlorine Residual

Sample tdentificalion/location Use Specific Address/ location identified in S-,mple

Sitinr,Pl;m R-lw \'/ells• U>e Source 10 for V/ell Sampled (Example:

G12l4S67Al

I-j-J-./-Ir . 5:.. 6 ✓

/J� ,'8' Of tO

Samplo Type : (-1 one)

l'K X Ix' X '{ '!. X y X l'K

Colloctcd

ID t"] l� /t,:'1-, -c-,It 1'7 11 /!Ji� l/dl1 /� /'.5'f r£;;� It 7 If J�J'l � trJ ? lq rJ:sf/ "i?:' !O 1(931J3�Ir) 1 1lf 1/:/0 � f(} 1 /q 'il/5 � ((J ? !Cf fi! Yf fi; IC 't 1� 6:/( �

Sar.-,;t!e ID & Oa:t o! Rejection Coda CnJna:r; 5a.,,,,:, Circle·,· tor Free. (� a�;f�e)•

(,-.:! Rc:,ca� T for Total. Please Replacemea:. &

(rnn.'L) Resubmit Tr,;ge,cd Raw ···,

Son:ples)

t)_(; � �.()) �

(,6q + (.61 + cl.6 Y(.'jlf � J..1 � .i. if -+J.O q,J./.. I<;

Date: Time:

Lab Results

Chlorine o/ Total Coltform

Absenl Present Absenl Presenl Absent Presenl /

Laboratory Sample ID Number

fiZf □ IZf

l!2J r

□ ill.izj □ � rzf □ l!ZI

/

t::J,, □ 0' E1 □ it]' l2f □ 0

�� □ � E) □ ij;I

□ 1'21 □ /{)0 'II ��K'S-□ l1t □ /<Po r19() U□ lid' □ /0[1 71 c;tJY) □ ut □ /tJO 7/9t?f;f'□ Ii.a' □ 11)0 7'/ '"ft!,/ 'l□ IZJ □ IJM'?I 9d 9a□ 0" D J()C) 7 I 9 tJ '7 J□ li2f □ V�/ 70 9 ]__,□ � □ /al?/�� �

ij2I' □ V&771 f/tJ 9'f □ Foon ins/1"1Jc1xlns: www.tceq.rcxas.l)Ol1dtin!ing"Nalcrlm.'aobi:i!l1oviscd-tolakc/Zonn-rulc . s� and CMln,C(jon samp:C$ /J/0 NOT FOR COMPUANCE Lab Rejec:ed Code (LR). Documcnl Reason: