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. SMALL WATER SYSTEM <br />OFFICIAL INSPECTION REPORT <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br />ENVIRONMENTAL HEALTH DIVISION <br />304 EAST WEBER AVENUE, STOCKTON, CA 95202 <br />(209) 468-3420 FAX (209) 468-3433 <br />Facility <br />r dc'h 4 <br />rsc <br />Date <br />/2• <br />pr p <br />Address ! 1 4' <br />17 <br />j <br />LEA 1D # <br />9n 1 q <br />Type of System L'! g, <br />7 f P J <br />R.E.>�.s. <br />1 <br />riPrin� <br />WA #6 r� <br />$ <br />V ab ym Pin,• f <br />Receive by <br />i <br />Phone # <br />ww <br />MV4 12'41 . 1 �/e <br />'o; <br />1 <br />444 <br />'V'r <br />pv►e�� <br />ait <br />u� <br />""e <br />5Al b - Ira hfs <br />�4r�-� he <br />s <br />��- <br />I' �d� ► �e <br />•� e. / <br />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 />EH04"1-002 Public Health 16 (8101) <br />Revised 8122101 Page of <br />