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00 <br /> 7- <br /> % BSK Mante8467 5 0 <br /> Me�eeca'; <br /> Client: Manteca Water Division Phone. (209)456-8467 <br /> * "' I IIII III II III VIII VIII III I II IIIIII VIII II — <br /> �.� address: 220 Oak Street Fax: (209)825-2583 � <br /> City,state,zip: Manteca,Ca.95337 system#: 3910005 EQavis@ci,manteca.ca.us c <br /> Cont2ctlpfo- Eric Davis Prolect Nome. Well <br /> ®' F <br /> .:Write-On <br /> ~ System <br /> Site Sampling Info Sample Status � 0_ #3910005 <br /> Date Time Cis(ppm) Routine Repeat U U) <br /> Well 24 Media -� - ........ <br /> 10, <br /> Sampled By: Pjjjjj0 I tojk 6 <br /> City of Manteca,Relinquished By Received By Signature Received By,Print Na a Date Time <br /> '�lRJ�1/1 1 it- & to <br /> w Nlv i 3 as <br />