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SAN JOAQUIN _j\'TY ENVIRONMENTAL HEALT EPARTMENT <br /> 304 East Weber Ave, 3rd Floor Stockton, CA 95201-2708 <br /> Phone: (209)468-3420 Fax: (209)468-3433 Web:WWW.SJCEHD.COM <br /> SMALL PUBLIC WATER SYSTEM PROGRAM OFFICIAL INSPECTION REPORT <br /> Facility Name: ST.- FP—AN(-AS MO-t-C-t, Date: a--`\-D-1 <br /> Address: cJ_)O1f N . t7W I 9 9 PWS ID#: r �oD57 z <br /> T ` <br /> Type of System: `l b 3� - R.E.H.S.: ll� WA#: Q 05�S <br /> Type of Service: P-O Ain t4 C— Received B Phone: <br /> GENERAL DESCRIPTION <br /> This system consists of_—well(s)and hydro pneumatic tank(s) l bladder tank(s). The distribution system <br /> consists of 'LO service connections serving a population of -\ residents/employees/customers/students. General land use in <br /> the surrounding area consists of agricultural,residential,commercial,industrial,rural,pristine,livestock enclosures. <br /> WELL(S)USED FOR: DOMESTIC INDUSTRIAL IRRIGATION FIRE STANDBY <br /> Treatment: <br /> CROSS-CONNECTION CONTROL <br /> ❑ Cross-Connection Control Survey ❑ Double Check Valve Assemblies(DCVA) <br /> ❑ Atmospheric Vacuum Breakers(AVB) ❑ Reduced Pressure Principle Assemblies <br /> ❑ Pressure Vacuum Breakers(PVB) ❑ Other backflow prevention devices <br /> All testable backflow prevention devices are required to be tested by a State certified tester annually and immediately <br /> after any installation or repair and the results submitted to the Environmental Health Department(EHD). <br /> ltJ A f iT, F L 1, t T U"/(T14 C.(-- Mt:NT. <br /> Titl722of e California Code of Regulations requires routine monitoring of your water system by a State certified laboratory. Sampling <br /> musrmed by State certified laboratory personnel. All samples shall be taken at the wellhead,except for bacteriological sampling. <br /> Thengly recommends the use of non-threaded,dedicated sample taps for bacteriological sampling in the distribution system. <br /> Bacteriological: Required quarterly/WwitW. Continue testing quarterly/W414 unless a sample tests positive for coliform. After a <br /> positive, four repeats must be taken within 24 hours of being notified by your laboratory and five routine samples shall be taken the <br /> following month. Please be aware that the bacteriological results collected for a system in a calendar month shall be reported to the EHD no <br /> later than the tenth day of the following month. <br /> 20 0 5 Nitrates: Required /annual! . <br /> 2005 Nitrites: Required /once every three years. <br /> Inorganic Chemicals: Required once every three years. The EHD current!y waives asbestos and cyanide. <br /> Volatile Organic Compounds VOCs): Required once every three/six years. <br /> Synthetic Organic Compounds(SOCs): DBCP and EDB are required once every three years. <br /> Lead and Copper: Required annually/once every three years. One complete sample set is to be taken between <br /> the months of June throu h Se tember. <br /> Secondary(Aesthetics): General Mineral and General Physical are due every 3 years. <br /> Radiological: Required every four years if compliance is met by conducting four consecutive calendar <br /> quarterly samples. <br /> Submit a copy of this form with all past due sample results . <br /> All past due lab results must be received by: Compliance date for all deficiencies: <br /> PLEASE BE AWARE THAT FAILURE TO CORRECT DEFICIENCIES BY COMPLIANCE DATE WILL RESULT IN STAFF TIME CHARGES OF$89 PER HOUR. <br /> EHD 46-01-001 Page I of SPWS Official Inspection Report <br /> Revised 02/21/03 <br />