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YSTEM OFFICIAL INSPECTION <br />TIME OUT <br />/L V'LkLocation <br />Disinfection <br />Filtration <br />Treatment Other <br />«t-ed <br />0 <br />9O.S C’\^ <br />n j /v-yPub. Notification Bact. <br />z> iiTC Zu-t+s <br />> ■& - c >x <br />Turb. Std. Not Met Chronic <br />Pub. Notification Turb. <br />Permit None Valid <br />Source <br />OFFICE ADDRESS AND PHONE NUMBER <br />PAGE OF <br />2/88 <br />Z <br />D a <br />No Operator <br />Cross-Con. Program <br />m <br />3 <br />Seed. Chem. Insult. <br />Seed. Chem. Std. Not Met <br />Turb. Insuff. Interm. <br />Turb. Std. Not Met Interm. <br />Storage <br />Distribution <br />Inorg. Insuff. <br />Inorg. Std. Not Met Nitrate <br />Inorg. Std. Not Mel 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. Insult. <br />Org. Std. Not Met Required <br />Org. Std. Not Met Other <br />Pub. Notification Org. <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 />Sewage <br />Activity <br />Flooding <br />Construction <br />Equip. Maint. <br />Records <br />MAJOR <br />DEF. <br />MINOR <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 />SMALL WATE YSTEM OFFICIAL INSPECTION -PORT <br />SAN JOAQUIN COUNTY PUBLIC HEALTH SERVxv.ES <br />ENVIRONMENTAL HEALTH DIVISION <br />445 N SAN JOAQUIN, PHONE (209)468-3420 <br />P 0 BOX 2009, STOCKTON, CA 95201 <br />o z <br />Q- <br />s <br /><n <br />SERVICE <br />< o <br />0 g <br />o <br />5 b s <br />Q a <br />U) <br />irS <br />in <br />I o <br />s <br />cc <br />5 <br />Q. <br />O <br />UJ <br />Oh <br />Oo-<z> <br />Orf <br />Consumer Acceptance Not Met <br />Turb. Insuff. Chronic <br />55 <br />56 <br />57 <br />58 <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 />51 <br />52 <br />53 <br />54 <br />24 <br />26 <br />(2 LLCt t <br />(2) (2 <br />OWNER/OPERATOR <br />1/4^ ^ArJ <br />PROGRAM/ELEMENT <br />MINOR w <br />3 <br />5: <br />_7__ <br />9 <br />W <br />12__ <br />14__ <br />16__ <br />18 <br />21 <br />NAME <br />QgaSeA- _______________ <br />LOCATION <br />it)I (TO <br />MAILING ADDRESS <br />MAJOR <br />~T~ <br />2_ <br />4 <br />6 <br />8__ <br />10 <br />11 <br />13 <br />15 <br />17 <br />i9i~ <br />20! <br />23; <br />25 <br />27 <br />28 <br />29 <br />30 <br />31 <br />32 <br />33 <br />34 <br />lag <br />REgE/ED BYj/;/ ‘ <br />SANITARIAN: <br />C /t f1 / 444-JK rfz? <br />c pyfe gyie <br />m(e. eC4A-— <br />Safety Inadequate <br />SYSTEM STATUS: (MARK ONE) <br />59 60□ ^f0R fl <br />EH-154 rev. <br />m <br />I <br />COMPUTER NUMBER <br />TIME IN <br />r'-vf <br />61 <br />NO I I DEF. || <br />DATE / j <br />RECHECK DATE 1