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for easy fill up of data entry after analysis of water test
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Flling of table:1Fill the information in the columns; If information is not available please mark as NA (Not Applicable)2
Client name Customer # Waterline Cleaner Room #
Sampling Site (Dr. Shapero)
Sno.1
(For definition see Legend)
1
Dr. Shapero R-172 Micrylium Lines
1 AWS
2TW
AWS
3
AWS
TW
HSH
In the column "BACTERIA INDENTIFIED" if described bacteria present in sample mark "
Fill the information in the columns; If information is not available please mark as NA (Not Applicable)
Test Date
Test Reults
(For definition see Legend) Volume (ml) Appearnce
mEndo
29-Nov-16
NEG
NEG
NEG
NEG
225
In the column "BACTERIA INDENTIFIED" if described bacteria present in sample mark "X".
Date of Receiving
Condition of samples on receiving
Heat Indicator activated
29-Nov-16
NEG
Test Reults
PCA (CFU/ml)
CA BCYE XLD BPA Average
NEG NEG NEG NEG 0 0 0
NEG NEG NEG NEG 0 0 0
5 TNTC NEG NEG 350 370 360
NEG NEG NEG NEG 0 0 0
NEG TNTC NEG NEG TNTC TNTC TNTC
NEG TNTC NEG NEG 0 0 0
Bacteria Identified
E.coli S. aureus S.enterica LegionellaTotal
Coliforms
Pseudomonas
aeruginosa
Comments Conclusion
as
