ADDRESS OF THE CUSTOMER :

TELEGRAM :
TELEPHONE ( S ) :
TELEX / E mail ID :
FAX :
TEST REPORT AS PER IS : [ WITH_AMENDMENT NO{s}______ ]
REPORT NO : IS : Dated :
PART A. PARTICULARS OF SAMPLE SUBMITTED

a) Sample Description :
b) Grade/Variety/Type/Class/Size etc :
c) Brand name, if any :
d) Declared values, if any :
e) Sample Code :
f) Batch No. & Control Unit No :
g) Quantity :
h) Nature of Packing :
i) Date of Receipt :
j) Date of Start of Analysis :
k) Date of Completion :
l) Manner of Sealing :
m) IO's signature :
n) Any other Information :
NOTES
1. This report, in full or in part, shall not be published, advertised, used for any legal action, unless prior permission has
been secured from the Director General, Bureau of Indian Standards. This report is intended for " BIS CERTIFICATION
MARKS PURPOSE ONLY “
2. This test report is ONLY FOR THE SAMPLE TESTED.

PART B. SUPPLEMENTARY INFORMATIONS

REPORT NO : IS : Dated :

a) Reference to sampling procedure, wherever applicable :

b) Supporting documents for the measurements taken : -
and results derived like graphs, tables, sketches and/or Photographs
as appropriate to test report, if any [ To be attached ]

c) Deviation from the test methods as prescribed in

 Relevant ISS/Work Instructions, if any : -

PART C. TEST RESULTS

Description :

REPORT NO : IS : Dated :

CL. SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REF. REQUIREMENTS
Microbiology
1 E.coli / 250 ml 5.1.1 IS : 15185 – 2002 Absent
2 Coliform Bacteria / 250 ml 5.1.2 IS : 15185 – 2002 Absent
Staphylococcus aureus /
3 5.1.3 IS : 5887 ( P 2 ) 1976 Absent
250 ml
4 Streptococci / 250 ml 5.1.3 IS : 15186 – 2002 Absent
Sulphite Reducing Annexure C of IS : 13428 –
5 5.1.4 Absent
Anaerobes / 50 ml 2005
Pseudomonas aeruginosa / Annexure D of IS: 13428-
6 5.1.5 Absent
250 ml 2005
7 Aerobic Microbial Count
@ 20 to 220C in 72 Hours,
a 5.1.6 IS : 5402 - 2012 Max 100
cfu / ml
b @ 370C in 24 Hours, cfu / ml 5.1.6 IS : 5402 - 2012 Max 20
8 Yeast and Mould / 250 ml 5.1.7 IS : 5403 - 1999 Absent
9 Salmonella / 250 ml 5.1.8 IS : 15187 - 2002 Absent
10 Shigella / 250 ml 5.1.8 IS : 5887 ( P 7 ) 1999 Absent
11 Vibrio cholerae / 250 ml 5.1.9 IS : 5887 ( P 5 ) 1976 Absent
Vibrio parahaemolyticus /
12 5.1.9 IS : 5887 ( P 5 ) 1976 Absent
250 ml

SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REQUIREMENTS
TABLE : 01
Organoleptic and Physcial Parameters ( Clause 5.2 )
1 Colour, True Colour Units, Max IS : 3025 ( P 4 ) 2
2 Odour IS : 3025 ( P 5 ) Agreeable
3 Taste IS : 3025 ( P 8 ) Agreeable
4 Turbidity, NTU, Max IS : 3025 ( P 10 ) 2
Total Dissolved Solids, mg / L,
5 IS : 3025 ( P 16 ) 500
Max
6 pH @ 250C IS : 3025 ( P11 ) 6.5 to 8.5
 SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REQUIREMENTS
TABLE : 02
General Parameters ( Clause 5.2 )
1 Barium ( as Ba ), mg / L, Max IS : 3025 ( P 2 ) 1.0
2 Copper ( as Cu ), mg / L, Max IS : 3025 ( P 2 ) 0.05
3 Iron ( as Fe ), mg / L, Max IS : 3025 ( P 2 ) 0.1
Manganese ( as Mn ), mg / L,
4 IS : 3025 ( P 2 ) 0.1
Max
5 Nitrate ( as NO3 ), mg / L APHA 22nd Edition -4500 C 45
6 Nitrite ( as NO2 ), mg / L, Max IS : 3025 ( P 34 ) 0.02
7 Fluoride ( as F ), mg / L, Max IS : 3025 ( P 60 ) 1.0
8 Zinc ( as Zn ), mg / L, Max IS: 3025 ( P 2 ) 5
9 Silver ( as Ag ), mg / L, Max Annexure J of IS : 13428 0.01
10 Aluminium ( as Al ), mg / L, Max IS: 3025 ( P 55 ) 0.03
11 Chloride ( as Cl ), mg / L, Max IS: 3025 ( P 32 ) 200
12 Selenium ( as Se ), mg / L, Max IS: 3025 ( P 56 ) 0.01
13 Sulphate ( as SO4 ), mg / L, Max IS : 3025 ( P 24 ) 200
Alkalinity ( as HCO3 ), mg / L,
14 IS : 3025 ( P 23 ) 200
Max
15 Calcium ( as Ca ), mg / L, Max IS : 3025 ( P 40 ) 75
Magnesium ( as Mg ), mg / L,
16 IS: 3025 ( P 46 ) 30
Max
17 Sodium ( as Na ), mg / L, Max IS : 3025 ( P 2 ) 200
Residual Free Chlorine, mg / L,
18 IS : 3025 ( P 26 ) 0.2
Max
Phenolic Compounds ( as
19 Clause 6 of IS : 3025 ( P 43 ) Absent
C6H5OH ), mg / L, Max
20 Mineral Oil, mg / L, Max Clause 6 of IS : 3025 ( P 39 ) Absent
Anionic Surface Active Agents (
21 Annexure K of IS : 13428 0.2
as MBAS ), mg / L, Max
22 Sulphide ( as H2S ), mg / L, Max IS: 3025 ( P 29 ) 1986 0.05
23 Antimony ( as Sb ), mg / L, Max IS : 15303 0.005
24 Borates ( as B ), mg / L, Max Annexure H of IS : 13428 5
25 Bromate ( as Br ), mg / L, Max ISO 15061 : 2001 0.01
TABLE : 03
Toxic Substances ( Clause 5.2 )
1 Mercury ( as Hg ), mg / L, Max IS : 3025 ( P 48 ) 0.001
2 Cadmium ( as Cd ), mg / L, Max IS : 3025 ( P 41 ) 0.01
3 Arsenic ( as As ), mg / L, Max IS : 3025 ( P 37 ) 0.05
 SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REQUIREMENTS
4 Cyanide ( as CN ), mg / L, Max Clause 2 of IS : 3025 ( P 27 ) Absent
5 Lead ( as Pb ), mg / L, Max IS : 3025 ( P 47 ) 0.01
6 Chromium ( as Cr ), mg / L, Max IS : 3025 ( P 2 ) 0.05
7 Nickel ( as Ni ), mg / L, Max Annexure L of IS : 13428 0.02
Polychlorinated biphenyle ( PCB
8 Annexure M of IS : 13428 Not Detectable
), g / L
Polynuclear aromatic
9 APHA 6440 Not Detectable
Hydrocarbons, g / L

SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REQUIREMENTS
ANNEX D
Pesticide Residues ( Clause 5.3 and 5.3.1 )
DDT ( o,p & p,p-isomers of DDT, 990.06 / 991.07, Chapter
1 NMT 0.0001 mg / L
DDE & DDD ) 10, AOAC 19th Edition
990.06 / 991.07, Chapter
2  - HCH ( Lindane ) NMT 0.0001 mg / L
10, AOAC 19th Edition

990.06 / 991.07, Chapter

3 ,  and  - HCH NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
4 Endosulfan ( ,  and Sulphate ) NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
5 Monocrotophos NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
6 Ethion NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
7 Chlorpyrifos NMT 0.0001 mg / L
10, AOAC 19th Edition
Phorate ( Phorate and its
Oxygen analogue that is 990.06 / 991.07, Chapter
8 NMT 0.0001 mg / L
phorate sulphoxide and 10, AOAC 19th Edition
phorate sulphone )
990.06 / 991.07, Chapter
9 2, 4 - D NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
10 Butachlor NMT 0.0001 mg / L
10, AOAC 19th Edition

990.06 / 991.07, Chapter

11 Isoproturon NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
12 Alachor NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter
13 Atrazine NMT 0.0001 mg / L
10, AOAC 19th Edition
 SPECIFIED
SL. No. TEST PARAMETERS TEST METHOD FOLLOWED RESULTS
REQUIREMENTS
ANNEX D
Pesticide Residues ( Clause 5.3 and 5.3.1 )
Methyl Parathion ( Methyl
Parathion and its oxygen 990.06 / 991.07, Chapter
14 NMT 0.0001 mg / L
analogue that is methyl – 10, AOAC 19th Edition
paraoxon )
Malathion ( Malathion and its
990.06 / 991.07, Chapter
15 oxygen analogue that is NMT 0.0001 mg / L
10, AOAC 19th Edition
malaoxon )
990.06 / 991.07, Chapter
16 Aldrin and Dieldrin NMT 0.0001 mg / L
10, AOAC 19th Edition
990.06 / 991.07, Chapter NMT 0.0005 mg /
17 Total Pesticide Rsidues
10, AOAC 19th Edition L

REPORT NO : IS : Dated :

PART D REMARKS -

Authorized Signatory