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Get Doh 360cuv 2018-2024

Public Water System Name: County: Town, Village or City: Reporting Month/Year: Date Report Submitted: MM/YYYY Gaseous Date Source(s) in use Source Water Type(s): MM/YYYY CHLORINATION Liquid Treated water volume Cylinder weight Chlorine used/Day (GALLONS/DAY) (LBS.) (LBS.) ULTRAVIOLET RADIATION/OTHER TREATMENTS Free chlorine Hypochlorite residual at added to crock entry point (GALLONS OR QUARTS) Surface Ground GWUDI Purchase with subsequent chlorination Purchase w/out subsequen.

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