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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 <br />I Public Health Services <br /> — health growa her , <br />CLIA ID 05D0643989 <br />Harmeet Kalif PhD, HCLD (ABB) <br />Submitter:San Joaquin County Environmental Health <br />1868 E. Hazelton Ave, STOCKTON, CA 95205 <br />2094683420 <br />Patient Name: Flooded Impact Well, Spigot <br />DOB: 01/01/1900 Gender: U Patient ID: <br />Patient Address:4724 E. Collier Rd., ACAMPO, CA 95220 <br />Ordering Provider: Sangalang, Scott <br />Ordering Provider N PI: Scott Sangalang <br />Collection Date/Time: 03/07/2023 09:45 <br />Received Date/Time: 03/07/2023 10:30 <br />Approval Date/Time: 03/08/2023 13:58 <br />Race: <br />County of Residence: San Joaquin <br />Sample ID: 2302974 <br />Comments: Water Source: Private Potable Water <br />Chlorine: NA <br />Collected by: Naseem <br />Sample 2117651 <br />cc: SJC Environmental Health Unit #5 <br />Ethnicity: <br />Water Colilert Approval Date/time: <br />03/08/2023 13 58 Order Status: <br />RESULT <br />MICROBIOLOGY FINDINGS <br />Colilert PA total <br /> <br />Total Coliform Absent <br />PA E. coli Absent <br />REPRINT: 03/09/2023 09:54 <br /> Page: 1 of 1