Portland Water District FROM 5.133.460 XE 1?0 Bail" David Onos April 19, 2016 Portland Public School System Portland, ME This letter is in response to your request for lead testing at 17 Portland public school facilities. Samples were collected following EPA Lead and Copper Rule sampling protocols. One (1) liter water samples were collected from 17 facilities on 16 and 3f30f1'6 and analyzed on 4/8/ 16 by EPA 200.5 inductively coupled plasma-optical emission spectroscopy. The PWD laboratory is certi?ed for this method through the Maine Department of Health and Human Services. Please refer to the table on the fellowing pages for your lead and copper results. Your lead results are all below the EPA action level. The EPA action level for lead is 15 micrograms per liter (ugfL) and the maximum contaminant level goal (MCLG) is zero. Water coming into your facility does not contain lead. If present, lead originates from interior plumbing and ?xtures. With the exception of one sample your copper results are below the EPA action level. The EPA action level for copper is 1.30 mg/L and the maximum contaminant level goal (MCLG) is also 1.30 mgfL. For additional information on lead and copper in your drinking water please refer to the attached fact sheet and visit'our website at If you have any questions about your results please reach us by email. Sincerely, Michael Koza Regulatory and Security Advisor Portland Water District mkoza@pwd.org The following de?nitions may be helpful in regard to the information provided above: Action Level: The concentration of a contaminant which, if exceeded, triggers treatment or other requirement which a water system must follow. Maximum Contaminant Level Goal (MCLG): The level of a contaminant in drinking water below which there is no known or expected risk to health. Sample Address Sample Location PPS La boratory Copper Lead - Identifier identification Result Result Number (111 g/ L) (.ttg/ .). Reiche School Kitchen - 166 BraCkett St' 1st Floor next to RCH-Z Portland greenhouse King Middle School EWC near 107 92 Deering Ave. Portland EWC near 207 Bayside Food service 353-1 353 Cumberland Ave. kitchen Portland 3rd floor breakroom 353?2 sink Portland High School BUbbler near 130 PHS-1 284 Cumberland Ave. Bubbler near 204 Portland East End School Bubbler near 128 EE-1 195 North St. Room 216 faucet EE-2 Portland Ocean Ave Elementary EWC across from 150 Ocean Ave. 113 Portland EWC in cafeteria Lyseth Elementary Bubbler across from LYS-1 171 Auburn St. . Portland Room 21 faucet Moore Middle School Bubbler outside 171 Auburn St. EWC next to 159 Portland Riverton Elementary Room 302 Riv-1 1600 Forest Ave. Room 401 Riv-2 Portland "ff. Longfellow Elementary Room 105 0.39 432 Stevens Ave. EWC off LNG-2 0.30 Portland .. .. Lincoln Middle School Water cooler in 0.55 522 Stevens Ave. cafetena . . I Water cooler <0.84 - Portland . main office - - Deering High School Ground floor water 0.15 <0.34 370 Stevens Ave. cooler - . - . Portland Water cooler in 126 DHS-2 w?160329?0041 0.17 "0.90 Sample Address Sample Location PPS Identifier Laboratory Identification Number- . Copper Result (mg/ L) Lead Res it lite/L) - Peaks Island Elementary Room 2 0.63 7.0 4 Church Ave. Kitchen faucet . 0.82 8.0 Peaks island Hall Elementary School Room 6 faucet HLL-1 0.29 1.7 23 Orono Rd. EWC outside HLL-2 0.20 1.3- Portland Presumpscot Elementary Teacher?s lounge 0.16 69 Presumpscot St. faucet - I 3 Portland Room 13 faucet PATHS 112 kitchen 196 Allen Ave. faucet Portland EWC outside 621 PTH-2 5 . Waldron Way Tilt skillet tap 92 Waldron Way Break room sink - ww?z w-150329-0051 Portland LEAD and COPPER in DRINKING WATER Important Information on How to Protect Your Health LEAD HEALTH EFFECTS Lead is a common metal that has been in many consumer products but is now known to be harmful to. human health if ingested or inhaled. It can be found in lead-based paint, air, soil, household dust, food, some types of pottery, and drinking water. Lead is rarely found in natural sources of water such as rivers and lakes or underground aquifers. When people come in contact with lead, it may enter their bodies and accumulate over time, resulting in damage to the brain, nervous system, red blood cells, and kidneys. Infants and children who drink water containing lead in excess of the action level could experience delays in their physical or mental development. Children could show slight de?cits in attention span and learning abilities. Lead in water can be a special problem for infants whose diets may be mostly ?uids, such as baby formula or concentratedjuices mixed with water. Smaller bodies can absorb lead more rapidly that bigger ones, so amounts of lead that won?t hurt an adult can be very harmful to a child. Adults who drink this water over many years could develop kidney problems or high blood pressure. COPPER HEALTH EFFECTS Copper is a reddish metal that occurs naturally in rock, soil, water, sediment, and air. It has many practical uses in our society and is commonly found in coins, electrical wiring, and pipes. It is an essential element for living organisms, including humans and, in small amounts, necessary in our diet to ensure good health. However, some people who drink water containing copper in excess of the action level over a relatively short amount of time could experience adverse health effects including vomiting, diarrhea, stomach cramps, and nausea. Some people who drink water containing copper in excess of the action level over many years could suffer liver or kidney damage. The human body has a natural mechanism for maintaining the proper level of copper in it. However, children under 1 year old have not yet developed this mechanism and, as a result, are more vulnerable to the toxic effects of copper. People with Wilson?s disease also have a problem with maintaining the proper balance and should also exercise particular care in limiting exposure to copper. People with Wilson?s disease should consult their physicians. HOW TO REDUCE YOUR EXPOSURE Lead may work its way into drinking water after the water has left the treatment plant and is on its way to people?s faucets. This usually happens through the corrosion of materials containing lead in household plumbing. These materials include brass faucets, lead solder on copper pipes, lead pipes or lead service lines connecting the water main to the inside plumbing. Lead pipes are no longer installed for service lines or in household plumbing, and lead solder has been outlawed in Maine since 1987. The amount of lead allowed in brass faucets has also been limited, but can still contribute some lead to drinking water (note that many faucets are made of brass even if they do not have a ?brass? color). Even with these restrictions in place, some homes-especially older homes-may still have signi?cant amounts of lead in their plumbing systems. Copper works its way into the water by dissolving from copper pipes in the household plumbing. The longer the water has stood idle in the pipes the more copper is likely to have absorbed. Newer homes with copper pipes may be more likely to have a problem. Over time, a coating forms on the inside of the pipes and can insulate the water from the copper in the pipes. In newer homes, this coating has not yet had a chance to develop. Thus, anytime the water has not been used for more than 6 hours overnight, for example, or during the day when people are gone to work or school -- it should be cleared from the pipes before being used for drinking or cooking. Let the cold water faucet run until you can feel the water getting colder, usually 30 60 seconds. The amount of time it takes will depend on your home and how its plumbing is arranged. Other Household water uses will also help clear standing water from the homes plumbing. For example, you may want to establish a routine of doing household tasks that use water such as showering, ?ushing the toilet, or running the dishwasher first thing in the morning before using water for drinking or cooking. Keep in mind that you?ll still need to ?ush individual faucets for a short time before using them for drinking water. Hot water dissolves leadfcopper more quickly than cold water so don?t use water from your hot water faucet for cooking or drinking. If you need hot water for cooking or drinking, take water from the cold tap and heat it. It is especially important not to use the hot water for making baby formula. Some treatment devices can reduce the amount of lead in your drinking water. Reverse-osmosis and distillation units can be used for that purpose. A few types of water ?lters also remove lead and copper. Check the product literature to be sure it has been certi?ed for metals removal by NSF International Also, you must follow the manufacturers recommendations for operation and maintenance to ensure that the treatment equipment works correctly. The water'you run from drinking water taps does not have to be wasted. You can use this water for cleaning purposes or for watering plants. You may want to keep a container of drinking water in your refrigerator, so you don?t have to run water every time you need it. Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plasticbottle to collect your water sample. The sample is to be collected alter the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water searplefor lead and copper analysis: 1. ?After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTENG SAMPLE. Place the open sample. bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap. the sample bottle and place in the sample bag provided. .Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3658-or Susan Jasper x3827 if you have any questions regarding these instructions. 4. Please off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday - Friday to or. C-GMPLETED BY searcher ass caresses were Sesame . :3 Waterwas last used: Time 3 Date ll 0?33 Sample was collected: Time 3 "39% Date 3.30 A I have read the above directions and have talEen. a tap sample in accordance with the directions. DVJ Signature Date 353 Comewob set. at? P?muo 353-? 1. 3% [39th How?? 1 Address r- Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper anabzsis: 1. 'After at least 6- hours of non-usage, collect the sample from the kitchen or bathroom colduwater faucet. 130 NOT RUN WATER BEFORE COLLECTING SAMPLE. "Place the open sample bottle below the faucet and gently .open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it- was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at ?7?4?=5961 x3658 or Susan Jasper x3 32?? if you have any questions regarding these instructions. 4. (PleaSe drop off Sample at FWD Customer Service 225 Douglass St. Portland Than-is You.) Hours: 8:30am to 4:30pm Monday - Friday Water was last used: Time? ?25 Date 0?9 Fi? Sample was collected: Time?r?f Data 3 35 I have read the above directions and have talcien a tap sample in accordance with the directions. 3 tu Dt Eggmcumeouaw momma er a6 jaBea Haste, Smoch aerosol.) Hum? Addre SS 1 Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directionsfor collecting water sampl?for lead and copper analysis: 1. ?Atter at least 6?1?10111?5 of note-usages collect the sample from the kitchen or bathroom. cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. - 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information 011 the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses Will be mailed to you Within 30 days of analysis completion. Call Rebekah Sirois at 774?5961 x3658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank Yea} Hours: 8:30am to 4:30pm Monday Friday Water was last used: Time a? r??d?gm Datcgl ?931g; .Sainple was collected: Time Date. ??91 I have read the above directions and have talEen a tap sample in accordance with the directions. gay ignature ate 18?; Eh . goo H'swl Address Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedm'e is described below. Directionsfor collecting water sample for food and copper duaifysi's: 1. After at least 6 hours of non~usage, collect the sample from the kitchen or bathroom cold~water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open. sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Doaglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday {0 BE COMPLETED Date #25 Date .3 e891 f%*ihe%/ _?aa/a gate-??! Date am Hate one?; Address - Water was last used: Sample was collected: Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directionsfor collecting water samptefor lead and copper analysis: l.?After at least 6 hours of non~usage, collect the sample from the kitchen or bathroom. cold-water faucet. DO NOT RUN- WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to. ensure that all information contained on the label is. correct. Complete the iafonnation on the. bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper x3 82?? ifyou have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday ?1?9 BE COMFLETED BY RESIBENT AND RETEURNED WITH SAMPLE Water was last used: Time-[0190 l9? Date 3 ?33?46 Sample was collected: Time 7501) AM Date 3 ?gin/6 I have read the above. directions and have talien a tap sample in accordance with the directions. Signature Date ?gs? can) ?64 - Mass.? 128 Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper enawsis: 1. ?After at least 6- hours of non-usage, collect the sample from the kitchen or bathroom cold?w.ater faucet. DO WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within .30 days of analysis completion. Call Rebekah Sirois tit-77469.61 x365 8. or Susan Jasper x3 827 if you have any questions regarding these instructions. To an as RESIDENT assassins-an WITH SAMPLE Water was last used: Time 1- 0 :50 Date 3 29 Sample was collected: Time 2 0 99137 Date 3 "is? I have read the above directions and have talien a tap sample in accordance with the directions. 329%; Signaiure Date may?? 6400 Wears/227? aewz? ?ew we Fascia? (id-fess -. a Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directionsfor collecting water sample for lead and copper sachets: 1. After at least 6 hours of nonwusage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap. the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the 'iaformation on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses Will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-6961 x3658 or Susan Jasper :13 827 if you have any questions regarding these instructions. 4. (Fleece drop off Sample at FWD. Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday - Friday Y0 . Water was last used: Tinsel 00 PM Date 3 8 Sample was collected: Time '73 ?13 at ?41 Date 3 "e1 I have read the above directions and have taken a tap sample in accordance with the directions. Sign??i'ture Date Hit; . Address I aid. Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefor lead and copper analysis: I. :Aiter at least 6 hours of non?usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. . - 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be-m?ailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3 82'? if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday Water was last used: Date .2 Time 19m 1 have read the above directions and have taken a tap sample in accordance with the directions. Sample was collected: Signature - Date . a, surmise. mm 2.. ddress Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefor lead and copper sesame.- l. ?A?er at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, filling the bottle. . cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full. sample bottle to the location where it was picked up. . The results of the analyses will be mailed to you within 3.0 days of analysis completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper KB 827 if you have. any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland. Thank You.) Hours: 8:30am to 4:30pm Monday Friday to as COMPLETED BY asstessr Ase caresses WITH SAMPLE Time 9?14 Date 3 ?28?{Ca Time 26 Am Date 3) k2"? Water was. last used: Sample was collected: I have read the above directions and have talien a tap sample in accordance with the directions. Signature moo. rim-beta, tel/715' Comm, Meant. to?? Address . . 37 42-? rl/t; Date Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper streams: 1. 'After at least 6 hours of nonnusage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. - 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analytics will be mailed to you within 3.0 days of analysis completion. Call Rebekah Sirois at 77416-961 x3 658 or Susan Jasper x3827 if you have any questions regarding these instructions. 4. {Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday Water was last used: Time 2?65 0&1 Date ?3-3 /57 Sample was collected: Time 935" Mi Date. 3? ?23 1?5 lhave read the above directions and have talien' a tap sample in accordance with the directions. ire-1Q as Date stigjm I MW fat/Jsz1 ?El WW Chats/eu- w/z 25.7 ddress . . Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water lead and copper analysis: 1. 'Atter at least 6 hours of non?usage, collect the sample from the kitchen or bathroom cold?water faucet. DO NOT RUN WATER BEFORE COLLECTENG SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, filling the bottle. 2. cap the sample bottle and place in the sample hag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3 658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. (Please droo off Sample at PWD Customer Service 225 Douglass St. Portland? Thank You.) Hours: 8:30am to 4:30pm Monday Friday TO BE EGMPLETED BY RESIEENT AND RETIJRNEB WITH SAMPLE Water was last used: Time 59/4?? Date 3 1:2 233 . Sample was collected: Time 6: ?f a? Date 615?? I have read the above. directions and have taken a tap sample in accordance with the directions. blag its?; Slg?t?ham ms aw ease. amsel Address I I I- 'a Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Hirections for collecting water sample for lead and capper analysis.? 1. After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold?water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this term and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3827 if you have any questions regarding these instructions. 4. (Please Sample Customer Service 225 Douglass St. Portland Thank Yen.) 0 4:30pm Monday - Fri-day Water was last used: I Time I 39 a PM Date 3 ?3-5 m" g? I Sample was collected: Time :50 A Date "f I have read the above directions and have tali'en a tap sample in accordance with the directions. Q. Signai?u Date ale-9mm Ewe MM thaw catered. Address Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six, hours. The collection procedure is described. below.? Directioasfar collecting water scream for lead and copper analysis.- 1. ?After at least 6 hours of nonnusage, collect the sample from the kitchen or bathroom cold~water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in. the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The. results of the analyses will be. mailed to you Within 30 days of analysis completion. Call Rebekah Siroi-s at 7746961 KB 658 or Susan JaSper 2413 8-27 if you have any questions regarding these instructions. 4. Please drop off Sample at FWD Customer Seryice 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm. Monday - Friday . seesaw ans aromas}; earn SAMPLE Water was last used: Time Date ""137 4 Sample was collected: Time 5: 25? 76?? Dates?? a I have read the above directions and have talien a tap sample in accordance with the directions. sea/6 Signature (7 Date Dear Homeowner: Please use the following instructions to preperly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper analysis: 1. After at least 6 hours of .nonwusage, collect the sample from the kitchen or bathroom cold?water faucet. DO OT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, filling the bottle. . 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to enSure that all information contained on the label is correct. Complete the information on the bottom of this fem and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah. Sirois at 774-6 961 x3658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. gPlcase drop off Sample at 3WD Customer Hours: 8:30am to 4:30pm Monday - Friday Wise 2125 on lass St. rtland Thank You. AML Water was last used: Date .3 ?a 3' ?xi 5 Sample was collected: Time 5:36 Date Q9 '2 4 I have read the above directions and have taken a tap sample in accordance with the directions. Sigaature i i Date mm feels) 1 Address I i - 42? Avg} Dear Homeowner: Please use the following instructions to preperly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six'hours. The collection procedure is described below. Directions for collecting water sample for lead and copper anahrsis: 1. 'After at least 6 hours of nonmusage, collect the sample from the kitchen or bathroom cold?wa_ter faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the. sample bag provided. Please review the sample kit label at this time to ensure that all infonrration contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you Within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper x3827 if you have any questions regarding these instructions. 4. (Please drop off Sam-ole at FWD Customer Service 225? Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday To as Br ash statesman WITH samLs Water-was last used: Time 739 Date 3 ~25] m? We Sample was collected: Time @250 am Date 3 ~30 I have read the above directions and have talien a tap sample in accordance with the directions. WM see/.4 Signature Date LT, 3 emit mm geta?LE-w edit/eats Wile-m (a ddress . 42; Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample'is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefor lead and copper ana?ysis: 'After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2.. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this than and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774?5961 x3658 or SDSan?Jasper KB 827 if you have any questions regarding these instructions. 4. (Please droo off Sample at PWD Customer Service 225i-Douglass St. Portland Thank You.) r. TO BE at RESIDENT Ara) narcissism a eta-Water was lastused: Time {0:150 117/74 Date Sample was collected: Time 5:5 Hm Date . - - 5 {53 A i" I have read the above directions and have talien a tap sample in accordance with the directions. Fin": 5 Lainey] sot-w 7-5 [3 cm. Signature 131? 5 .w Date amen area asva a? i Cg" Address aa- art/Wt (law we?? Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to he collected after the water has remained motionless in the pipes for at least six hours. The collection proCedure is described- below. Directioasfor collecting water sempiejbr lead and copper anemia: After at least 6 hours of non?usage, collect. the sample from the kitchen or bathrOOm coldnwater faucet. D0 NOT RUN WATER BEFORE COLLECTING sesame. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is information on the bottom of this form and return the form and ran sample bottle to the location Where it Verac- picked up. 3. The results of the. analyses will bef-mai-Ied to you within 30- days of analysis. completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper 33827 if you have any questions regarding these instructions. 4. {Please droo. oil?Samole at PWD Customer Service 225 Doualass St. Portland Thapk You.) Hours: 8:30am to 4:30pm Monday Friday . ro er. eomrmree er reasonable-ass RETURNEB Wire SAMPLE Water was last used: - Time [3191) PM Date 17 Sample was collected: Time ?fO Date '3 3 ?3?wa I have read the above directions and. have taken a tap sample in accordance with the directions. W2 - Signature I Date" $6 1 "Magma ewe - Address, *3 Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and capper analysis: 1. 'After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom coldnwatel' faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. . 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3827 if you have any questions regarding these instructions. 4. (Please dron off Sample at FWD Customer Service 22.5 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday . ?to as (Jessamine as assistant also screens!) WITH. SAMPLE Date "?167ng I Date C915 I have read the above directions and have talien a tap sample in accordance with the directions. 5; Sighature Date Water was last used: Time {Grew f7"? Time diffs-5" . Sample was collected: [fl/team. momma, Sort?ect? one 3 we '70 15"? Address 4.2. Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hour . The collection procedure is described below. Directions for collecting water samplefor lead and copper mob/2312's: 1. ?lter at leastlo hours of momma-rage, collect the sample from the kitchen or bathroom Cold-?water faucet. DO NOT RUN WATER BEFORE Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Cemplete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within '30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. (Please drop off Sample Customer Service 225 Douglass St. Portland'fl? hank You.) Hours: 8:30am to 4:30pm Monday Friday . TO BE coMrLETse er newness AND seep-mac am SAMPLE Water was last used: Time /C>i ITO PM Date - 3 9 ?7/9 Sample was collected: Time 35? {Ml Date 3? ?9 I have read the above directions and have taken a tap sample in accordance with the directions. 39% are We? we? we Signature Date WC ac?ers? W14 Ocean: AWE: 1W Address I ?r EL 45:; Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper analysis: 1. 'A?er at least 6 hours of non?usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois- at 774-5 961 x3658 or Susan Jasper 2:3 827 if you have any questions regarding these instructions. 4. ?ilease drop off 3! ample at PEI) Customer Service 225 Qopglass gt: Portland Thanh Yum Hours: 8:30am to 4:3 0pm Monday Friday - Water was last used: Time {@3067 Date - 9x5?? Sample was collected: Time dam I have read the above directions and have talEen a tap sample in accordance with the directions. 2930 M: Signature Date @a?eu Rafi. Mama? Odd? an; as a Address .412, gr Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the. water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper analysis: 1. 'A?er at least 6 hours of nonsusage, collect the sample from the kitchen or bathroom cold?water faucet. DO NOT RUN WATER BEFORE. COLLECTING SAWLE. Place the open. sample bottle below the faucet and gently Open the cold water tap, filling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked-up. 3. The results of the analyses will be mailed to-you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper x3 82'? if you have any questions regarding these instructions. 4. (Please drop off Sample at 9WD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday Water was last used: Time 300 1 Date 3234-}? g. Sample was collected: Time 5 :52? EM have read the above directions and have talien a tap sample in accordance with the directions. I s/w/e Date. Signature ?6.45?an gaff. I Address 2. .- Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collectng water lead and copper analysis: 1. 'After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom _of-this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper x3 82?? if you have any questions regarding these instructions. 4. (Flease drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday - Friday . as Water was IaSt used: I Time - Datefg egg/? 1 Sample was collected: Time Date {Igg? I have read the above directions and have talien a tap sample in accordance with the directions. y/aa?a Signagre Date, swarms?. Address 1. After at least 6 hours of non?usage, collect the sample ?ee; the kitchen or bathroom cm. DO NOT RUN WATER BEFORE SAWLE. Place the open sample be, faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle?ind place in the sample bag provided. Please review the sample this time to ensure thaI all won-nation contained on the label is correct. Cemplete the informal bottom of this fem: and retinal the form and sample bottle to the location whese it was piekee 3. The results if the analyses will be mailed to you Within 30 days of ?analysis Sirois at 774-5961 x3658 or Susan Jasper 323827 if you have any questions -. - 4. {Please Ciro; eff Sam's-1e at FWD Cusmmer Sewiee 225 Deu;=- - Home: 8:303:11 to 4:30pm Monday a Friday Water was last useci: "Sample was collected: I have read the above directions and have taken a tapieamiajl?e in Sigmmre 0 K3 1. fie?lg 55w. Dear Homeowner: Please use the fol-lowing instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motion-less in the pipes for at least six hours. The collection procedure is described below. Directions for collectiag water sample for [sad and copper analysis: 1. ?After at least 6 hours of non-usage, collect the sample from the kitchen or- bathroom cold~water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on. the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the-analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper 2:3 827 if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday - - Water 'was last used: Sample was collected: I have read the above directions and have talien a tap sample in accordance with the directions. at, Mm elm/(w Signature ?314 0 51C Date - canes a Pl Address Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefer lead and copper analysis: 1. ?After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold?water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the. open sample bottle below the faucet and gently open the cold water tap, ?lling. the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the Sample kit label at this time to ensure that all information Contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 x3658 or Susan Jasper 33827 if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday - so Water was last u'sed: Time PM Date 3.8.3 9 Sample was collected: Time 3 1745/52/37 Date I have read the above directions and have talizen a tap sample in accordance with the directions. 3e29r/? we melt. VHS 1. Date tame/L 53va Home 13:) Address mad?an Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directioasfor cottecting water sample for lead and copper analysi 1. 'After at least 6 hours of non?usage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap. ?lling the bottle. 2. cap? the sample bottle and place in the sample bag provided. Please review the sample kit label at this time tolen'sure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you with-in 30 days of analysis completion. Call Rebekah Sirois at 774-6961 x3658 or Susan Jasper x3 827 if you have any questions regarding these instructions. 4. (Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) To as. eon/rename er AND Ramadan were sesame Time Date Timq?z ?m Date ?2 C: I have read the above directions and have tallies a tap sample in accordance with the directions. Em ?3 2?3 wit, Signature Date Feta?"es. edit) Watch 50% 4.1 Wig-5r 2. ?u??taL Nan/L 520% ?gs/cg; Water was last used: Sample was collected: Address Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Birectionsfor collecting water sample for lead and copper analysis: 1. ?After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold?water faucet. DO NOT RUN WATER BEFORE CDLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, filling the bottle. 2. cap the sample bottle and place in. the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom ofthis form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion, Call Rebekah Sirois at 77469651 x3 658' or Susan Jasper x3827 if you have any questions regarding these instructions. 4. Please drop off Sample at PW Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:303:11 to 4:3 0pm Monday Friday Water was last used: Time lam Datewg ?23 Sample was collected: Time 75/5" Date I have read the above directions and have talE'e-n a tap sample in accordance with the directions. .3 Signature Date Mamie/773W 79,23." 1 '?acmf? ewes-a arrow" Address by" 4/24 Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to he collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefor lead and copper anabsis: 1. ?After at Beast 6 hours of non-usage, collect the sample Item the kitchen or bathroom coldwwater faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the Sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Si-rois at 7746961 x3658 or Susan Jasper xii 827 if you have any questions regarding these instructions. 4. LPlease off Sample at FWD Customer Service 225 Doug-lass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday - Friday to as (Jessamine as answerer arse RETURNEB WITH seams. Water was last used: Time I 0 100 Wm Date Sample was collected: Time in Date I have read the above directions and have taken a tap sample in accordance with the directions. 1 32:2? w/e Signature Date ?Page omPS? c: {Zoom f3 Address r; 47' f$ Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to he collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sample for lead and copper analysis: 1. After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold-water faucet. B0 NOT RUN WALTER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, filling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label. is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah. Siroi-s at 774-5961 x3658 or Susan Jasper xii 827 if you have any questions regarding these instructions. 4. {?ame drop off Sana-ole at FWD Q, astomer Service 225 Douglass St. Portland Thank You; Hours: 8:30am to 4:30pm Monday Friday Ti) BE BY RESIIEENT AND WETH Water was last used: Time 1/ 0 ?36-0 Date 3 "?23 [a Sample was collected: Time i 0'3 Am Date ?3 9 I have read the above directions and have taken a tap sample in accordance with the directions. i? 4/6 0 305W Lets 12122 cm. Address ature Bate taxman saucer {2.014 1. Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. - Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directionsfor collecting water seemlefor lead and copper analysis: 1: After at least 6 hours of non-usage, collect the sample from the kitchen or bathroom cold?water faucet. DONOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sainple bottle below the faucet and gently open the cold water tap, filling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete. the information on the . bottom of this form and return the form and full sample bottle to the location. where iit'was picked up. 3. The results of the, analyses will be mailed to you. within 30 days of analysis completion. Call Rebekah Sirois at 77455961 16658 or Susan Jasper X3 827. if you have any questions'regardin?g these instructions. 4. Please drop off Sa'n?lhle at PWD Customer Serviee 225 Bod-glass St. Portland hank You.) Hours: 8:30am-to: 43:30pm Monday -j Friday - . . Water. was last used? . Time PM Date 3? Seinple was collected: Time :0 Date 3 I 1 have reed theabove directions and have taken a tap sample in accordanoe'vigith the directions. . I .s. Signature I Date . tree. :3 are) ?ow .- mp ijOLj teem Cleo seems. WrevJ'E, WW sass. ?g - .9 ?y Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for callect?ieg water sample for lead and copper doublets: 1. 'After at least 6 hours of nonausage, collect the sample from the kitchen or bathroom cold-water faucet. DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. - 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you Within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Sleeper x3 82?? if you have any questions regarding these instructions. 4. {Please drop off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday Friday - are an committee BY Rasmaan? sec anemone WITH SAMPLE Water was last used: Time (9?9 Date, Sample was collected: Time r} a - Date I have read the above directions and have taken a tap sample in accordance with the directions. a? Date Address I I I Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected alter the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Bir?ctionsfor collecting water sample for lead and copper analysis: 1. 'A?er at least 6 hours of non~usage-, collect the sample from the kitchen or bathroom coldmwater faucet. DO NOT RUN WATER. BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and. place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 7746961 KB 65 Sor Susan Jasper x3327 if you have any questions regarding these instructions. 4. [Please drop off ?ample at FWD Customer Service 2 5 Do Water was last used: Time Date_3~ ?g 6? Sample was collected: Time 0 Dateg?? :52 6 I have read the above directions and have talien a tap sample in accordance with the directions. 5? 251% 6 Signature Date Address . 4'3. Dear Homeowner: Please use the following instructions to properly collect a lead sample from your home. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water sampiefor lead and copper anawsis: 1. 'After at least 6 hours of nonnusage, collect the sample from the kitchen or bathroom cold?water faucet. . DO NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and full sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774-5961 x3658 or Susan Jasper KB 827 if you have any questions regarding these instructions. 4. gPlease drop off Sample at Customer gargiee 225 Dogglass St. Portland Thank You: Hours:? 8:30am to 4:30pm Menday Friday to Be owe it. . Water was last used: Time gr; ?33 gr?. Date Sample was collected: Time 3-01) Date 3 ve read the above directions and have talzen a tap sample in accordance with the directions. Signet i 5 MW cps-55? Date WethW/h ddress . . . mar,? Dear Homeowner: Please use the following instructions to properly collect a lead sample from your heme. Use the enclosed 1 liter plastic bottle to collect your water sample. The sample is to be collected after the water has remained motionless in the pipes for at least six hours. The collection procedure is described below. Directions for collecting water samplefar lead and copper analysis: 1. After at least 6 hours of non?usage, collect the sample from the kitchen or bathroom cold-water faucet. DD NOT RUN WATER BEFORE COLLECTING SAMPLE. Place the open sample bottle below the faucet and gently open the cold water tap, ?lling the bottle. 2. cap the sample bottle and place in the sample bag provided. Please review the sample kit label at this time to ensure that all information contained on the label is correct. Complete the information on the bottom of this form and return the form and fall sample bottle to the location where it was picked up. 3. The results of the analyses will be mailed to you within 30 days of analysis completion. Call Rebekah Sirois at 774?5961 x3658 or Susan JaSper x3827 if you have any questions regard-ng these instructions. 4. Please droo off Sample at FWD Customer Service 225 Douglass St. Portland Thank You.) Hours: 8:30am to 4:30pm Monday - Friday It} BE BY RESEDENT AND WITH SAMPLE Time Ems Date Sl?yll? Time la?w?x Date Water was last used: Sample was collected: . cad the above directions and have taken a tap sample in accordance with the directions. Sisal! l; Date Slgnature mem imfh or; was? Address