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San Joaquin County DIRECTOR Donna Heran, REHS "r'" Environmental Health Department ASSISTAN7DlRECTOR �. o 600 East Main Street Laurie Cotulla, REHS Stockton, California 95202-3029 PROGRAM COORDINATORS ' Mike Huggins, REHS, RDI c: q Website: wwwsjgov.org/ehd Margaret Lagorio, REHSRobertMcClellon, REHS Q�IFOR Phone: (209) 468-3420 Jeff Carruesco, REHS,RDI Fax: (209)464-0138 Kasey Foley, REHS April 1, 2009 Kent W Raverty Trust ` 100 East Taddie Road Acampo, CA 95220 F Subject: Kent W Raverty Trust Water System, 100 East Taddie Road, Acampo CA The San Joaquin County Environmental Health Department (EHD) has been informed that the well on the above mentioned property serves at least 25 or more individuals at least 60.days out of the year, or serves a food facility and additional service connections (i.e. a residence). This is the definition of a Transient Non Community Water System (TNCWS). All owners of a property with an on site well that serves water for domestic uses, which meets the definition of a non-community public water system, are required to apply to the EHD for a permit to operate a public water system.' To proceed with applying for a permit to operate a TNCWS from the EHD, fill out the enclosed forms and return them to the attention of Unit IV at EHD with the required permitting fees within 30 days of receiving this letter, as detailed below. 1. Complete the Public Water Supply Permit Application form. 2. Complete and sign the gold Service Request and blue and green Masterfile Record forms. 3. Complete the Emergency Notification Plan. 4. Complete the Water System Declaration Form to determine the use of the water. 5. Provide a copy of a valid driver's license of the person signing the application. 6. Provide a Tax ID Number or the Social Security Number of the person signing the application. 7. Submit a check in the amount of $630 for the TNCWS Permit Application fee. Please make the check payable to EHD. 8. Submit a check in the amount of $483 for the TNCWS annual operations fee. Please make the check payable to EHD. The Kent W Raverty Trust must submit the following information to the EHD in order to demonstrate that the well meets the standards of the California Code of Regulations Water Works Standards, the Health and Safety Code Safe Drinking Water Act, the State of California Water Well Standards, and requirements of San Joaquin County Well Standards as a TNCWS source. I Any person who operates a public water system without a permit issued by the department (aka EHD) pursuant to this chapter may be liable, as determined by the court, for a civil penalty not to exceed twenty-five thousand dollars ($25,000)for each separate violation or, for continuing violations, for each day that violation continues (Health and Safety Code Section 116725 (d)).