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SITE INFORMATION AND CORRESPONDENCE (2)
Environmental Health - Public
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2900 - Site Mitigation Program
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PR0541936
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SITE INFORMATION AND CORRESPONDENCE (2)
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Last modified
5/18/2020 11:15:09 AM
Creation date
5/18/2020 10:55:56 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2900 - Site Mitigation Program
File Section
SITE INFORMATION AND CORRESPONDENCE
RECORD_ID
PR0541936
PE
2957
FACILITY_ID
FA0006149
FACILITY_NAME
RANCH MARKET
STREET_NUMBER
23569
Direction
S
STREET_NAME
SANTA FE
STREET_TYPE
RD
City
RIVERBANK
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
23569 S SANTA FE RD
QC Status
Approved
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EHD - Public
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ENVIRONMENTAL HEALTH DEPARTMENT <br /> a,aU.IN SAN JOAQUIN COUNTY Unit Supervisors <br /> Carl Borgman,R.E.H.S. <br /> Donna K.Heran,R.E.H.S. 304 East Weber Avenue, Third Floor Mike Huggins,R.E.H.S.,R.D.I. <br /> Director <br /> Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> At Olsen,R.E.H.S. Mar aret Lagorio,R.E.H.S. <br /> Program Manager Telephone: (209) 468-3420 g <br /> • cqC/F o Ra�P Robert McClellon,R.E.H.S. <br /> Laurie A.Cotulla,R.E.H.S. Fax: (209) 464-0138 Mark Barcellos,R.E.H.S. <br /> Program Manager <br /> March 19, 2004 <br /> NAGI SALEH-ALI MOHAMED GUBARY <br /> DURHIM ALI JUBARI PO BOX 1322 25 POCETTA DR #201 <br /> 667 O,FARRELL ST #10 <br /> SAN FRANCISCO CA 94109 RIVERBANK CA 95367 DALY CITY CA 94015 <br /> Re: Ranch Market Water System, 23569 S. Santa Fe Rd., Riverbank, CA <br /> The San Joaquin County Environmental Health Department (EHD)has been informed that the new well <br /> on the above mentioned property serves at least 25 or more individuals at least 600 daysout <br /> o a property <br /> f the year. <br /> This is the definition of a Transient Non Community Water System (TNCWS). <br /> All uses,whic <br /> tic <br /> pwith an on siteublic water systeem,are qrequired t watermeets the ervesapply t EforSHD for a permit o operate definition publicc w ter system�umty <br /> To proceed with applying for a permit to operate a TNCWS from EHD, fill out the enclosed forms and <br /> return them to the attention of Unit IV at EHD with the required permitting fees within 30 days of <br /> receiving this letter,as detailed below. <br /> 1. Complete the Public Water Supply Permit Application form. <br /> 2. Complete and sign the blue and green Master File Record forms. <br /> 3. Complete the Emergency Notification Plan. <br /> igning the application. <br /> 4. Provide a copy of a valid driver's license of the person s <br /> 5. Provide a Tax ID Number or the Social Security Number of the person signing the application. <br /> 6. Submit a check in the amount of$310 for the TNCWS Permit Application fee. Please make the <br /> check payable to EHD. <br /> 63 for the TNCWS annual operations fee. Please make the <br /> 7. Submit a check in the amount of$3 <br /> check payable to EHD. <br /> A new water system must submit the following information to EHD in order to demonstrate that the <br /> system meets the standards of the Safe Drinking Water Act and requirements of San Joaquin County Well <br /> Standards as a TNCWS. <br /> 1. Provide EHD a detailed schematic of the property showing the location of the well,pressure tank, <br /> backflow prevention assemblies,water lines (i.e. irrigation, fire, and domestic),the <br /> existing/proposed septic system, and a 100%replacement septic area. <br /> 1 Any person who operates a public water system without a permit issued by the department(aka EHD)pursuant to this <br /> vil penalty <br /> t to exceed <br /> enty-five th <br /> eachtsepaz to violation or,,for determined <br /> violations,for each day that violation continues(Health and Safety Code Seusand dollars ction <br /> 116725116725(d)). <br />
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