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6 San Joaquin County <br />Public Health Services <br />health grows here <br />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 />CLIA ID 05D0643989 <br />Harmeet Kaur Ph.D, HCLD (ABB) <br />Submitter:San Joaquin County Environmental Health <br /> Patient Name: Impacted Well, Well Sample Tap <br />1868 E. HazeIton Ave, STOCKTON, CA 95205 <br /> DOB: 00/00/0000 Gender: U Patient ID: <br />2094683420 <br /> Patient Address:3550 Marfargoa Dr., STOCKTON, CA 95215 <br />Ordering Provider: Sangalang, Scott <br />Ordering Provider NPI: Scott Sangalang <br />Collection Date/Time: 02/07/2023 09:30 <br />Received Date/Time: 02/07/2023 10:09 <br />Approval Date/Time: 02/08/2023 15:17 <br />Race: <br />County of Residence: San Joaquin <br />Sample ID: 2301661 <br />Comments: Water Source: Private Potable Water <br />Chlorine: N/A <br />Collected by: Aaron Gooderham <br />Sample #2117648 <br />cc: SJC Environmental Health Unit #5 <br />Ethnicity: <br />Water Coined Approval Date/time: <br />02/08/2023 15:17 Order Status: Final <br />RESULT <br />MICROBIOLOGY <br /> <br />FINDINGS <br />Colilert PA total <br /> <br />Total Coliform Absent <br />PA E. coli Absent <br />REPRINT: 02/09/2023 14:07 <br /> Page: 1 of 1