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<br />CITY OF PARIS <br />ENVIRONMENTAL SERVICES LABORATORY <br />SAMPLE CUSTODY SHEET/REPORT <br /> <br />CUSTODY NUMBER: S- <br /> <br />SAMPLE SITE: <br /> <br />SAMPLE TYPE: (CHECK ALL THAT APPLY) <br /> <br />WASTEWATER: <br />BYPASS (LIFT STA.) <br />BYPASS (OTHER) <br />SPECIAL <br /> <br />WATER: <br />DISTRIBUTION <br />PLANT <br />WELL <br />SPECIAL <br /> <br />SAMPLE DATE/TIME: <br /> <br />AM/PM <br /> <br />SAMPLE DELIVERED BY: <br /> <br />DATE/TIME: <br />DATE/TIME: <br /> <br />AM/PM <br />AM/PM <br /> <br />SAMPLE RECEIVED BY : <br /> <br />TESTS TO BE RUN (CHECK ALL THAT APPLY) <br /> <br />TEST: RESULTS: TEST: RESULTS: <br />BOD-5 mg/L ALK. mg/L <br />TSS mg/L Cu mg/L <br />VS mg/L Fe mg/L <br />_pH mg/L Mn mg/L <br />NH3 mg/L S04 mg/L <br />FLUORIDE mg/L <br />CL2 RESID. mg/L <br />TURBIDITY NTU <br />F. COLIFORM COLONIES/100 ml <br />T. COLIFORM COLONIES/100 ml <br />SPEC. GRAV. <br />SEND RESULTS TO: <br /> <br />COMMENTS: <br /> <br />(SCUSTODY.DW3) <br />REVISED 10-30-91 <br />