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SAMPLE SITING PLAN <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT <br /> / FWMS t?,176 <br /> Name of Watet SystemPS Code <br /> W� ad C PA ,lPS <br /> Owner(s) <br /> z 07- <br /> Number of service connections Number of customers <br /> Name of Certified Laboratory Name of Sampler (If not Laboratory) Certified by <br /> Name(s) and Phone Number(s) of Person(s) Laboratory are to Contact Following <br /> Any Positive S�p ple: �v(;_ ,/O�_ �� / cQ�� <br /> tc1 YI�.K fM�SS tr►'1PY -1 q a <br /> Contact #1 Day Night Cell <br /> e-mail <br /> Contact #2 Day Night Cell <br /> e-mail <br /> (CDO CTO) Day Night Cell <br /> e-mail <br /> Bacteriological monitoring frequency: Monthly�uarterly_ Seasonal_ of: <br /> Monthly from: Quarterly from: <br /> Addresses or Locations of Rou ine and Repeat Sample Sites: <br /> Routine #1 (R <br /> The four Repeat samples shall be collected within 124 hours of notification <br /> that the Routine sample failed at the following locations, using enumerated <br /> test methods with chlorine residuals reported on the test result: <br /> Repeat #1 Same ov <br /> Repeat #2 ,, t'ay5 <br /> A <br /> Repeat #3 1 1 ,z <br /> Repeat #4 Wellhead— A 0 <br /> Routine #2 <br /> Repeat #1 <br /> Repeat #2 <br /> Repeat #3 <br /> Repeat #4 <br /> By signing below, I hereby submit this sample siting plan and authorize the above- <br /> mentioned State certified laborat to release and submit copies of all analytical <br /> results for this water system to he an Joaquin County Environmental Health <br /> Department. Q <br /> Submitted by: Date: ��/ 13 <br />