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FRENCH CAMP RV PARK <br />P.O. BOX 1500 <br />FRENCH CAMP, CA 95231 <br />ATTN: STEVE <br />P. 0. Box 355 <br />6602 2nd Street COPY T0: <br />Etiverbank, CA 95367 <br />FAX TO: <br />EMAIL TO: <br />SAN JOAQUIN CO <br />COLLECTED BY: <br />Phone 209-869-9260 <br />Fax 209-869-2278 <br />State Certification #1310 <br />A. MARTINEZ <br />DATE COLLECTED: <br />8/4/2015 <br />DATE/TIME RECEIVED: <br />814/2015 / 1600 <br />DATE/TIME STARTED: <br />8/4/2015 / 1700 <br />DATE/TIME COMPLETED: <br />8/5/2015 / I715 <br />DATE REPORTED: 8/6/2015 <br />BACTERIOLOGICAL TEST FOR COLIFORM BACTERIA IN DRINKING WATER <br />STD. METHODS #9223 <br />CERTIFICATE OF ANALYSIS <br />SAMPLE ADDRESS: 3919 E. FRENCH CAMP RD, MANTECA <br />SYSTEM # 3901377 <br />TOTAL E. COLI <br />TIME FWL# SAMPLE SAMPLE RESID COLIFORM COLIFORM <br />COLL LOCATION TYPE CL2 BACTERIA BACTERIA <br />(MPN/100mL) (MPN/100mL) <br />1055 A184 RESTAURANT HOSEBIB 3A N/A ABSENCE ABSENCE <br />IF ANY SAMPLE INDICATES AN "ABSENCE" OF TOTAL COLIFORM BACTERIA, <br />IT MEETS STATE STANDARDS FOR COLIFORM BACTERIA. <br />IF ANY SAMPLE INDICATES A "PRESENCE" OF TOTAL COLIFORM BACTERIA, <br />IT DOES NOT MEET STATE STANDARDS FOR COLIFORM BACTERIA. <br />SAMPLE TYPE: 1 - WELL REASON FOR TEST: A - ROUTINE <br />2 - WELL TANK B - REPEAT <br />3 - DISTRIBUTION SYSTEM C - SPECIAL <br />4 - SURFACE WATER/ SOURCE <br />5 - OTHER <br />PERSON NOTIFIED: <br />DATE/TIME NOTIFIED: <br />�i <br />/A—SIGNATURE: LORATORY DIRECTO <br />