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f <br />Name of Certified Lal <br />SPWS Contact (172 /3',J) <br />Monthly from:- ^ecez-^trQuarferly from: <br />Addresses or Locations of Routine and Repeat Sample Sites: <br />Same a; above <br />Ropeat #2 sample site at west side of building <br />Ropoat #3 hOSO bib at northeast corner of buildinq <br />Repeat #4 Weiihe,-»t!($) <br />Routine #2 <br />Repeat #1 <br />Repeat «2 <br />Repeat #3 <br />Repeat #4 <br />any <br />Sample SrrtNG Plan <br />San Joaquin CouNn' Environmental Health Department <br />Pacific Bell <br />Owners) <br />3901006 <br />PS Code <br />Pacific Bell UE17L________________ <br />Name of Small Public Water System (SPWS) <br />e-mail_ _V\\ck<-A . <br />following locations, using enumerated tost methods with chlorine residuals reported on (he te$t result *: <br />Repeat #1 <br />liohf/Ceti <br />^\\l€ e A Kuicyp. c <br />—‘ Dato:_ ♦ 2.0 • 2016 <br />live Repeat or E.coli/focal result by ttw) end of the day. <br />Number of service connections N^ber ofcustordere <br />Cerco Kn(x\y|>cM / t'CeVisi <br />Name of Certified Laboratory Name of Sampler (it not laboratory) Certified by <br />(CDO/CTO)(1I’/2'73'T <br />Namofs^and Phone Numbor(s) of Porson(s) Laboratory are to Contact Foltowing Any Positive Sample in order of <br /> <br />SPWS Contact (I54/ <br /> /____________ <br />Day Night/Cell <br />e-mail. x <br /> r L^n) <br />Day v , \ , Nioht/Cell <br />e-ma*™ OCjCbU'L(i' trJ UJctlS _ <br />Bacteriological monitoring frequency: Monthly 0 Quarterly Seasonal of: <br />Routine #1 samolg site at bP?t Side of building . <br />Tho fgyr Repeat samples shall be collected within 24 hours of notification that the Routine sample failed at the <br />By signing below, I hereby submit this sample siting plan and authorize the above-mentioned State certified laboratory Io <br />r^wiso ond submit copes of all analytical results for this water system to tho San Joaquin County Environmental Health <br />Submitted by: <br />'Owner or Oponrtj/^lfalro^i^’ihaJ>fl