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San Joaquin County Public Health Laboratory <br /> 1601 E. Hazelton Ave <br /> STOCKTON,CA 95205 <br /> / PH:209-468-3460,FAX:209-468-0639 <br /> San Joaquin County CLIA ID 05DO643989 <br /> Public Health S�?rvic-�?s FLAP# 1892 <br /> Harmeet Kaur Ph.D, HCLD(ABB) <br /> Submitter:San Joaquin County Environmental Health Patient Name: River Oak Dairy 39 349, Sample Tap Southwell <br /> 1868 E.Hazelton Ave, STOCKTON, CA 95205 DOB:01/01/1900 Gender: U Patient ID: <br /> 2094683420 Patient Address:29770 E.Hwy 4, FARMINGTON, CA 95230 <br /> Ordering Provider:Sangalang, Scott Race: Ethnicity: <br /> Ordering Provider NPI: Scott Sangalang County of Residence San Joaquin <br /> Collection Date/Time:04/15/2024 09:45 Sample ID:2404617 <br /> Received Datelliime:04/15/2024 10:53 <br /> Approval Date/Time:04/16/2024 15:42 Comments: Chlorine: NA <br /> Water Source: Private Potable Water <br /> Collected by:Naseem Ahmed <br /> Sample ID:2116870 <br /> CC:SJC Environmental Health Unit##5 <br /> Water Colilert Approval Dateltime: Order Status: <br /> 04/16/2024 15:42 <br /> RESULT <br /> MICROBIOLOGY FINDINGS <br /> Colilert PA total Total Coliform Absent <br /> PA E. coli Absent <br /> REPRINT: 04/16/2024 16:45 Page: 1 of 1 <br />