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Healthy Communities

Notice to Water Operatior


Please take a moment to read the enclosed “Instructions for Sampling” and look over the Lead and Copper Rule “Sample Collection Report”.

The Sample Collection Report lists your water system’s sample sites and site codes in sequence with 12 sites per page.

Make a copy of the “Instructions for Sampling” for each customer who will collect a sample.  For example, if you need to collect 10 samples, you will need 10 copies of the Instruction form.

The customer should read the instructions carefully and write down the date and time they last used the water tap, and the date and time they collected the water sample. The elapsed time between the two events must be at least 6 hours. The water must remain motionless in the pipes for at least 6 hours.

Please take the information the customer provided on the “Instructions for Sampling” form and transfer this information onto the Sample Collection Report. 

The Certification Form and the Sample Collection Report must accompany your samples. If any of the forms are missing, the samples will not be processed. It is best to place both forms in a waterproof container, such as a freezer bag.

When submitting samples, your PWS identification number must precede the individual site number. All sample bottles must be labeled properly using a label or permanent marker.  Sample bottles that are not labeled will be rejected, and resampling will be required.

Samples must be collected from an indoor tap typically used for consumption. Usually, the kitchen or bathroom sinks. Collect the sample from the cold water tap. Do not collect the sample from the hot water tap. Collect the samples from the primary sites using your Lead and Copper Sampling Site Plan.

Use the boxes supplied to you by the Arkansas Department of Health for sample shipment. The boxes are labeled to ensure your samples are routed to the correct analytical laboratory when received by the Public Health Laboratory. Samples should arrive at the lab within ten days of collection.

Affix one of the enclosed mailing labels for the Public Health Lab to each box. Deliver your samples to the local County Health Unit. The County Health Unit will arrange for shipment to the Public Health Lab. If you don’t have mailing labels, please address each box as such:

                    Arkansas Department of Health
                    Public Health Laboratory
                    Slot 47
                    201 South Monroe
                    Little Rock, AR 72205

Attention: Inorganic Laboratory

Water samples for Lead and Copper analyses

You may also deliver the samples to the Public Health Lab yourself. It’s located at 201 South Monroe Street, Little Rock, 72205. Samples must be delivered to the receiving area at the rear of the building off South Palm Street.

If you have questions regarding sample collection, sampling forms, sample shipment or your sample site plan, please call Kaleb Lee at 501-661-2623 or e-mail


Public Health Accrediation Board
Arkansas Department of Health
© 2017 Arkansas Department of Health. All Rights Reserved.
4815 W. Markham, Little Rock, AR 72205-3867