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Name of Certified Laboratory <br />sW ■■Name(s) of Sampler(s) <br />■Day <br />Night <br />Day <br />cU Night <br />Quarterly: <br />Quarterly from: <br />Routine #1 <br />test <br />Repeat #1 <br />f K / p)Repeat #2 <br />Repeat #3 <br />WellheadRepeat #4 <br />Routine #2 <br />Repeat #1 <br />Repeat #2 <br />Repeat #3 <br />Repeat #4 <br />Iment <br />3Date:Submitted by: <br />at&t <br />Your world Delivered <br />c 3 /T-1 Connie Mitchell <br />Environmental Site Manager <br />AT&T Services, Inc. <br />2300 E. Eight Mile Road <br />Stockton, CA 95210 <br />T: 209.474.4022 <br />M: 209.598.5155 <br />F: 209.952.0827 <br />cm1919@att.com <br />Monthly from: <br />Addresses or Locations of Routine and Repeat Sample Sites <br />Same as above____ <br />hose i <br />_____ ___________Cbfr" <br />Trained by (if not Laboratory Personnel) <br />monitoring frequency: ) <br />K- <br />Seasonal <br />y’Q <br />___________/___Vo. <br />Number of service confections <br />cell *'"■ <br />2>H~I M irtA. <br />4 hours of not if Treat ion <br />J) _____ <br />Number of Residents or Average Number <br />of Persons Served per Month <br />(//i«t^> <br />__f I J <br />' itel'aborate below) <br />I hereby submit this sample siting plan and authorize the <br />, silz of' b <br />CO^ <br />__i.._ ;:i Zam-ple ______T_7__ ________ <br />The four Repeat samples shall be collected within 24 hours of.notif <br />that the Routine sample failed at the following locations, using enumerated <br />methods with chlorine residuals reported on the test result: <br />and Phone Number Is-Lof Person (si Laboratory <br /> -'UTt <br />Sample Siting Plan Ps Code. <br />San Joaquin County Environmental Health . <br /> crA_“- <br />Name of Water System <br />Owner(s) <br />By signing below, I hereby submit this sample siting plan and. aumorize une <br />above-mentioned State certified laboratory to release and submit copies of all <br />analytical results for this water system to the San Joaquin County <br />Environmental Health “ <br />^axe to Contact Following' Name(s) <br />(4? W i Any Positive Sample: <br />k w 4t /id AUSot __.____ <br />Contact #1 > <br />^|vdL__ <br />Bacteriological <br />Monthly: