Revised Total Coliform Rule Lab Sampling Form - This form should be completed when a water system collects any required Revised Total Coliform Rule (RTCR) samples. It should also be used when collecting “Special” non-compliance samples for the RTCR. The revised form has a column for chlorine residual, if your system adds disinfectant. Please submit this form to your lab along with their chain of custody to record where and when samples were collected and for what purpose. This template is also available in MS Word format.

• Revised Total Coliform Rule Lab Sampling Form (PDF)(1 pg, 129 K, 12/08/2017)