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DATE <br />OWNER/OPERATOR <br />TIME OUT <br />' /o <br />Location <br />Disinfection <br />Filtration <br />Treatment Other <br />11 <"s <br />c? , Ce-i r-re. <br />C! <br />< S <br />Pub. Notification Bad. <br />-A <br />Ze <br />j Z-g // be.E.i^ec-o<\ce <br />c^£t'/-e^r\ <br />Turb. Std. Not Met Chronic <br />EE t'E LeEtEEc.Pub. Notification Turb.el — <br />Permit None Valid <br />/n.4Source <br />IPAGE <br />® M EH-154 rev.2/88 <br />CD <br />3 <br />Storage <br />Distribution <br />Inorg. Insult. <br />Inorg. Std. Not Met Nitrate <br />Inorg. Std. Not Met Selenium <br />Inorg. Std. Not Met Fluoride <br />Inorg. Std. Not Met Mercury <br />Inorg. Std Not Met Arsenic <br />Inorg. Std. Not Met Other <br />Pub. Notification Inorg <br />Org. Insuff. <br />Org Std. Not Met Required <br />Org. Std. Not Met Other <br />Pub. Notification Org. <br />Seed. Chem. Insutt <br />Seed. Chem. Std Not Met <br />Number of Samples Insuff < 4 Samp <br />Number of Samples Insuff. 4-8 Samp <br />Number of Samples Insuff >8 Samp. <br />Std. Not Met For <4 Mo <br />Std. Not Met For 4-8 Mo <br />Std. Not Met For >8 Mo. <br />No Operator <br />Cross-Con. Program <br />Equip. Maint. <br />Records <br />MAJOR <br />DEF. <br />The marked items represent Health Code violations and must be cor­ <br />rected as follows: <br />Storage <br />Piping <br />Cross-Con. Problem <br />Sewage <br />Activity <br />Flooding <br />Construction <br />0 z <br />Q_ <br />5 <br />CO <br />z <br />Z) o <br />/ r f a / <br />y j <br />SERVICE <br />Z7 <br />DC <br />LU <br />T <br />Q <br />J <br />S <br />Ct <br />< o <br />0 g <br />o <br />£ <br />o <br />2 <br />Q <br />£ <br />CO <br />£ <br />o <br />ui <br />Of- <br />OQ- <br />Lail Ee-EE ^-vilC Ct ! r <br />c/c>xj2 -E rEaE ■ <br />C&A ■ 2- <br />$ y)E <br />Consumer Acceptance Not Met <br />Turb. Insutt. Chronic <br />Turb. Insutt. Interm <br />Turb. Std. Not Met Interm.51 <br />52 <br />53 <br />54 <br />55 <br />56 <br />57 <br />58 <br />31 <br />32 <br />33 <br />34 <br />35 <br />36 <br />37 <br />38 <br />39 <br />40 <br />41 <br />42 <br />43 <br />44 <br />45 <br />46 <br />47 <br />48 <br />49 <br />50 <br /><r Ei-e <br />MINOR w <br />_3_ <br />5 <br />7 <br />9 <br />12__ <br />14__ <br />16 <br />18 w <br />21 <br />22 <br />24 <br />26 <br />OFFICE ADDRESS AND PHONE'NUMBER <br />MAJOR <br />2___ <br />4 <br />6 <br />8__ <br />10 <br />11 <br />13 <br />15 <br />17 <br />19 <br />20 <br />23 <br />25__ <br />27 <br />28 <br />29 <br />30 <br />-5 <br />(CLa yi / <br />Clzt. i tr i 'cl, t <br />Capley y c'c’-S-cc bE <br />a a i cvTg I Eea bhE ^E)i UiS <• <br />HaecJ^ I (c> <br />St <br />ica ! cc^/) Lt /cS <br />CDi <br />iEa &ELL. <br />LOCATION <br />^300 E. EtMT <br />MAILING ADDRESS COMPUTER NUMBER <br />TIME IN <br />^Ee^iCql E-C E E A A <br />1■E' C' E—t- <br />i C(t\.aL <br />A>E Acs zb-cc.. <br />PROGRAM/ELEMENTEle^O <br />SANITARIAN: ' - <br />of.3 <br />Cao. -E.1 >■ <br />61 <br />N° I I DEF. || <br />Safety Inadequate <br />SYSTEM STATUS: (MARK ONE) <br />59 60 <br />MINOR I IDEF. I| <br />E o - Et)c <br />(~a Le C~e i' <br />SMALL WAT SYSTEM OFFICIAL INSPECTIC REPORT <br />SAN JvwQUIN COUNTY PUBLIC HEALTH SEL..CES <br />ENVIRONMENTAL HEALTH DIVISION <br />445 N SAN JOAQUIN, PHONE (209)468-3420 <br />P 0 BOX B009, STOCKTON, CA 95201 <br />tW------------------------------------------- <br />ct'~y/L-C(Et, Ec-sEi <br />ac H (- C- 13/ ^/ez~/7 c^s. <br />la 1)c a-