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2180 Fox Street - 03-117-23-31-0005
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Last modified
8/22/2023 4:36:33 PM
Creation date
10/17/2016 2:28:05 PM
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x Address Old
House Number
2180
Street Name
Fox
Street Type
Street
Address
2180 Fox St
Document Type
Septic
PIN
0311723310005
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� 3 <br /> Twin City Water Clinic Laboratory Test Report Minnesota State Laboratory ID#027-053-119 <br /> Wisconsin State Laboratory ID#105-10117 <br /> CIIE?Ilt: Don Stodola Well Drilling Co Report Number: ii-o236s Twin City Water Clinic Inc. <br /> Sample Collection Date: iz/ia/ii 617 13th Avenue South <br /> A[ICICESS: 3841 North Main Street Sample Collection Time: is:oo Hopkins, MN 55343 <br /> St.Bonifacius,MN 55375 Sample Receipt Date: iz/is/ii Phone: (952)935-3556 <br /> Report Issue Date: iz/i5/ii Fax: (952)935-5077 <br /> Laborator Analyte Client ID Parameter Sample Prep Sample Analysis Test <br /> Sample ID Date Time Date Time Results Units <br /> 11-12193 Coliform Drinking Water 12/15/11 11:56 Absent <br /> 11-12193 Nitrate/N Drinking Water 12/15/11 11:40 <1.0 mg/I <br /> 11-12193 Arsenic Drinking Water 12/15/11 9:00 12/16/11 10:40 3.16 µg/I <br /> Lead Drinking Water µg/I <br /> Drinking Water <br /> Drinking Water <br /> Drinking Water <br /> X No samples were subcontracted;or the above test result(s) Well No.: 788Z35 <br /> with'**'designation were produced by a subcontracted Sample pt: <br /> laboratory. Well Adr: 2180 Fox St Orono,MN <br /> [Laboratory name;address;MDH Lab ID#]. <br /> The subcontracted laboratory Owner: George Ebbecke <br /> maintains MDH Certification for the field(s)of testing Owner Adr: <br /> Sample Conditions: <br /> SampleTemperature: 9 °C <br /> Discussion: <br /> Notes: <br /> Approved methods used in analyzing the samples This Sample meets the <br /> listed above have the following reporting levels: Maximum contaminant levels: State of Minnesota, <br /> SM92226- Coliform-<1 cfu/100 ml <br /> Wisconsin and EPA <br /> Coliform, 1 cfu/100 ml Nitrate Nitrogen 10.0 mg/I <br /> Arsenic, 10.0 µg/I guidelines for safe <br /> SM4500D-Nitrate Nitrogen, 1.0 mg/I drinking water for the <br /> SM 3003-Arsenic, 2.0 I �ead, 15.oµg/I <br /> µg� analytes tested. <br /> L; :'.. ' <br /> � <br /> ', _ �r.�t�:�,�'�.�z�.�' <br /> Sample Collected by: X Client _TCWC Approved By: _ � � <br /> Bill Van Arsdale Alan Senechal <br /> Laboratory Manager Senior Analyst <br /> The results listed in this report apply only to the above listed samples. All routine quality assurance <br /> procedures were followed, unless otherwise noted.This analytical report must be reported in its entirety. <br /> All methods are certified by the Minnesota Department of Health, unless otherwise noted. <br /> TCWD Rev 1.2 Page 1 of 1 <br />
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