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Dii .ribution Data <br /> <br />No: <br /> Date: <br />t crC>Pressure Range: <br />/jo <br />ucr’C^ <br />Defects and Remarks: <br />Revised: 12/7/92 <br />System Name: <br />Source of Information: <br />Collected By: <br />State of <br />California <br />Office of <br />Drinking Water <br />Department of <br />Health Services <br />Dead Ends (extent):__________ <br />Growth and sludge in mains: <br />Flushing: <br />Infiltration Hazard:__________ <br />(Relationship to groundwater <br />table, underwater lines, etc.) <br />/J^^- <br />tPu /■ J C-O • <br />Distance of Mains from Sewers: <br />(Past practice, future policy) <br />Disinfection (method): <br />New Mains:_____________ <br />After Repairs: <br />Materials: <br />Mains:__________________ <br />Condition:_______________ <br />Lead, copper, brass (extent) <br />Joints <br />i <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 Regulations: <br />u)&-^ mP-AD <br />Pyc. i(V/* <br />A. A AT