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Fact Sheet How to Complete a Coliform Lab Slip 331-247 I Revised January 2022 Page 1 It is important to fill out the lab slip completely. The Department of Health Office of Drinking Water (DOH) may not be able to give you credit for sample results if the date, time, system ID number, system name, or type of sample is missing or incomplete. The lab slip contains three sections: the first two for the person collecting the sample and the third for the lab. Section 1: Basic Sample and Water System Information Date Sample Collected: Two-digit month, day, and year the sample was collected. For example 02/05/2022. Time Sample Collected: Time sample collected. Check AM or PM. County: County location for the water system.* Type of Water System: Group A, Group B, or Other.* Water Facilities Inventory (WFI) ID#: The five– six character water system ID number (include numbers and letters).* System Name: Name for this water system registered with DOH.* Contact Person: List the person the lab or DOH staff should contact with questions about this sample. Day/Cell/Evening Phone and Email: List the best way to reach the contact person. Send results to: List the best mailing and email address for the lab to send the results. Sample collected by: List the person who collected the sample. Specific location where sample collected: Describe in detail the sample location point. Specific instructions or comments: Include any specific instructions for the lab. ---PAGE BREAK--- Page 2 Section 2: Sample Purpose (Coliform Sample Type) Routine Distribution Sample Public water systems must take this sample on a routine basis. o Chlorinated: Mark “Yes” or “No.” o Chlorine Residual: List measured Total and/or Free chlorine results. Repeat Sample Public water systems must take this sample after a coliform- present routine sample. o Distribution System Sample: Take at a sample tap in the distribution system. o Unsatisfactory routine lab number: List the lab and sample ID number from the original unsatisfactory sample. o Unsatisfactory routine collect date: Enter collection date for the original unsatisfactory sample. o Chlorinated: Mark “Yes” or “No” for repeat sample. o Chlorine Residual: Enter measured Total and/or Free chlorine results. Ground Water Rule Source Sample: o List the source ID number here: . o Triggered Groundwater system must take a raw sample following a coliform-present sample. o Assessment DOH directed some public water systems to monitor their groundwater source for 12 months even if they have no coliform-present routine samples. Surface or GWI Raw Source Water Sample (Enumeration): There are two types of surface water or GWI systems in Washington state: 1. Unfiltered surface or GWI systems (as of 2021 there are only three in Washington) a. They must follow the federal Surface Water Treatment Rule monitoring guidelines as outlined in WAC 246-290, PART 6 – Surface Water Treatment, Subpart A – Introduction and General Requirements. b. The hold time for routine coliform samples from this type of system is 8 hours. c. Mark the microbiological slip as unfiltered. d. Mark the analysis for totals or fecal. e. The results must be enumeration and not an absence/presence result. f. The source must be clearly identified using the space provided. ---PAGE BREAK--- Page 3 2. Filtered surface or GWI systems. a. They must follow the additional state Surface Water Treatment Rule monitoring guidelines as outlined in WAC 246-290, PART 6 – Surface Water Treatment, Subpart B – Requirements for Filtered Systems. b. The hold time for routine coliform samples from this type of system is 30 hours. c. Mark the microbiological slip as filtered even though the sample is taken before filtration. Marking the coliform slip as “filtered” establishes that the sample is being analyzed as part of the state surface water treatment requirements. d. Mark whether the analysis is for fecal or E.coli. e. The results must be enumeration and not an absence/presence result. f. The source must be clearly identified using the space provided. Sample Collected for Information Only: Check if sample for engineering purposes, construction or repairs, a home sale, or other uses. These samples do not need to go to DOH for processing. Section 3: Drinking Water Results Unsatisfactory: Check if sample is total coliform-present AND E. coli present OR E. coli absent. Satisfactory: Check if no coliforms detected. Bacterial Density Results: Record the colony count or most-probable number if the test yields it (both are enumeration methods). Replacement Sample Required: Check if sample is not viable for any reason, such as “too old” or “volume less than 100ml.” Date and Time Received: Enter the date and time the laboratory received the sample. Lab Reference Number: Lab staff generate this number for in-laboratory tracking. I.e., Invoice Numbers or Project Numbers (Optional) Receipt Temp Required for unfiltered surface water samples. Method Code: Enter the code for the analytical method used to analyse the sample (SM-9223B or SM- 9222B, not MICR codes). Date Reported to DOH: Enter the date the lab reported the result to DOH. ---PAGE BREAK--- Page 4 DOH Lab-Sample#: Enter the three-digit DOH-assigned lab number and then the five-digit lab- assigned sample ID number. Lab Use Only: A space for the lab’s own purpose. For example, details about the water system being informed of the result. Resources *This information is on your Water Facilities Inventory form and Sentry at fortress.wa.gov/doh/eh/portal/odw/si/Intro.aspx. **See Follow-up to an unsatisfactory routine coliform sample 331-187. For more information Our publications are online at doh.wa.gov/drinkingwater. Contact our nearest regional office from 8 AM to 5 PM, Monday through Friday. If you have an after- hours emergency, call [PHONE REDACTED]. Eastern Region, Spokane Valley [PHONE REDACTED]. Northwest Region, Kent [PHONE REDACTED]. Southwest Region, Tumwater [PHONE REDACTED]. To request this document in another format, call 1-[PHONE REDACTED]. Deaf or hard of hearing customers, please call 711 (Washington Relay) or email [EMAIL REDACTED].