EHS FORM NO. 127 ® Republic of the Philippines Province of Cebu Municipality of San Remigio OFFICE OF THE MUNICIPALITY HEALTH OFFICER CERTIFICATE OF POTABILITY This is to certify that the results of water samples collected from PANG! MULTI-PURPOSE COOPERATIVE (PMC) (Sampling Point) at __LAMBUSAN, SAN REMIGIO, CEBU - (Address of Sampling Point) on __JANUARY 24, 2023 _ showed that the water supply have passed the requirements (Date of Collection) set by the Philippine National Standard for Drinking Water for physical and chemicals (aesthetic, organic, inorganic, disinfectant and disinfectant by products), biological, bacteriological and radiological quality. Based on these results, the _ San Remigio Drinking Water Quality opt sername ; {City/muricipaity) |» Monitoring Committee, (DWQMC) hereby recommends the issuance of this cetificate to aa ILTI-PURPOSE COOPERATIVE (PI of _lambusan, San Remigio, Cebu By (Name of Applicant) (Address of Applicant) Recommending Approval: By Authority of the Secretary of Health: BAL Municipal Health OfficerRESULTS OF WATER ANALYSIS: [FacilityLeve: I] SSC=S Le = J Province * Cebi Municipality | San Remigio. 7 o Barangay * | Lambusan — Household Name * | Pangi Multi-Purpose Cooperative : Site : 7 : i This is to certify the water supply facility classified under the level and location of afordescribed, has been examined by the Department of Health Laboratory and passed its minimum requirements, as attested to by the result of laboratory analysis, in terms of: Bacteriological Impurities - Escherichea (e. coli) Total Coliform X | Physical & Chemical Impurities = Taste - Nitrate Odor = Total Hardness > Ph - fron - Turbidity = Sodium - Chloride = Sulfate - Total dissolved solids Other Parameters (please specify) ‘This certificate is valid until: | December 31, 2023 —————————— ‘Thereafter subsequent samplings and analysis will be covered by a corresponding certification. Recommended for Approval: —ELVERA A. PILAPIL ——DR.ORLETA B. URSAL __ S janitary Inspector Rural Health Officer