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State of D om` . r i b u t i o n Data Department of <br />California Health Services <br />Office of <br />Drinking Water <br />System Name: No: <br />Source of Information: <br />Collected By: Date: <br />Materials: <br />Mains:` <br />2 ti PVc T OVC G+Lvt iAQa. <br />Condition: <br />Lead,copper, brass extent ,-0,�f- <br />Joints <br />Distance of Mains from Sewers: <br />(Past practice, future policy) <br />_Disinfection (method): <br />New Mains: <br />After Repairs: <br />G J-i-L,-)tz / r <br />Infiltration Hazard: <br />(Relationship to groundwater <br />table, underwater lines, etc.) <br />Pressure Range: `f v — (o v L u -s <br />Cross - Connection <br />and Backflow <br />Prevention: <br />Private Supplies (kind and <br />extent) <br />Cross Connections: <br />With other potable: <br />With non -potable: <br />Plumbing Code or Requlations: <br />C % U+Lue t- c K. U.aLv� r �� itio ��•�� ova��S <br />Nu>0--r <br />n. o 4.ic <br />Dead Ends (extent): .�` FRS M Q C �Lr cd <br />Growth and sludge in mains: <br />Flushina: <br />Defects and Remarks: <br />Revised: 12/7/92 <br />41 <br />41 <br />