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SR0083415_SSNL ADDENDUM
Environmental Health - Public
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SR0083415_SSNL ADDENDUM
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Last modified
2/24/2022 1:21:10 PM
Creation date
2/23/2022 5:06:40 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
FileName_PostFix
SSNL ADDENDUM
RECORD_ID
SR0083415
PE
2602
FACILITY_NAME
88 MARKET & GRILL
STREET_NUMBER
21850
Direction
E
STREET_NAME
LIBERTY
STREET_TYPE
RD
City
CLEMENTS
Zip
95227
APN
02120024
ENTERED_DATE
3/16/2021 12:00:00 AM
SITE_LOCATION
21850 E LIBERTY RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
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EHD - Public
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Sample Siting Plan I <br /> San Joaquin County Environmental Health Department <br /> 88 Market Water System TNC <br /> Name of Small Public Water System(SPWS) ++ PSCode 3902216-001 <br /> 88 Market Steve Khanshali 3902216-001 <br /> Owner(s) WA# <br /> 3 4 <br /> Number of Service Connections Number of Customers <br /> Farwest Labs <br /> Nameof Certified Laboratory Nameof Sampler(If not Laboratory) Certified by <br /> Names(s)and phone number(s)of person(s)Laboratory are to Contact Following Any Positive Sample in orderof <br /> 1st/2nd/3rd Choice: <br /> Steve Khanshali 1 209-605-2370 209-605-2370 <br /> SPWS Contact 1st Day Night/Cell <br /> e-mail: ooasis3CJgmail.com <br /> Gus Alburati 2 209-423-2100 209-423-2100 <br /> SPWS Contact 1st Day Night/Cell <br /> e-mail: alburati@fzmail.com <br /> X Sam Hedge 3 X 209-406-6069 209-406-6069 <br /> SPWS Contact 1st Day Night/Cell <br /> e-mail: samhedge(aDcaldsl.net <br /> Bacteriological monitoring frequency: Monthly_j_Quarterly_Seasonal of: <br /> Monthly From: Quarterly From: <br /> Addresses of locations of Routine and Repeat Sample Sites: <br /> Routine#1 Inside Restroom <br /> The four repeat samples shall be collected within 24 hours of notification that Routine samples failed at the <br /> following locations,using enumerated test methods with chlorine residuals reported on the test result': <br /> Repeat#1 _ Same as Above <br /> Repeat#2 _ South Side Mkt XHB <br /> Repeat#3 _ North Side Mobi I Home XHB <br /> Repeat#4 . Wellhead(s) <br /> Routine#2 South Side Mkt XHB <br /> Repeat#1 - SameasAbove <br /> Repeat#2 - North Side Mobil Home XHB <br /> Repeat#3 - Inside Restroom <br /> Repeat#4 _ Wellhead(s) <br /> By signing below,I hereby submit this sample siting plan and authorize the above-mentioned state certified Laboratory to <br /> release and submit copies of all analycal results fort ' ystem to San Joaquin County Environmental Health <br /> Department. <br /> Submitted b Date: Date: 5/30/2021 <br /> Sam 4;dgeWaiW6rer91kr45891 <br /> Owner or Operator shall notify the EHD any positive Repeat or E.coli/fecal result by the end of the day. <br />
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