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DATE <br />TIME OUTSERVICE <br />MAJOR <br />//Location <br />Disinfection <br />/lSFiltration <br />Treatment Other <br />J- <br />Pub. Notification Bad. <br />Seed. Chem. Insult. <br />Seed. Chem. Std. Not Met <br />Turb. Insutf. Interm. <br />Turb. Std. Not Met Interm. <br />Turb. Std. Not Met Chronic <br />Pub. Notification Turb <br />Permit None Valid <br />Source <br />OFFICE ADDRESS AND PHONE NUMBER <br />61 <br />ORIGINALEH-154 rev.2/88 <br />Storage <br />Piping <br />Cross-Con. Problem <br />Equip. Maint. <br />Records <br />No Operator <br />Cross-Con. Program <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 />Inorg. Insuff. <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 />Storage <br />Distribution <br />MINOR <br />DEF. <br />NO <br />DEF. <br />The marked items represent Health Code violations and must be cor­ <br />rected as follows:Sewage <br />Activity <br />Flooding <br />Construction <br />0 <br />Z <br />Q. <br />< <br />0 <br />Z <br />Z) <br />0 <br />< o <br />0 g <br />o <br />E <br />o <br />CD <br />COMPUTER NUMBER <br />TIME IN <br />02 <br />£ <br />LU <br />I oI <br />s <br />Q <br />E <br />CD <br />EQ. o <br />CD <br />02 p <br />UJ <br />Oi- cro zxr Oo. cn <br />Consumer Acceptance Not Met <br />Turb. Insuff. Chronic <br />27 <br />28 <br />29 <br />30 <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 />51 <br />52 <br />53 <br />54 <br />55 <br />56 <br />57 <br />58 <br />24 <br />26 <br />1 <br />6 <br />_8 <br />10 <br />11 <br />13 <br />15 <br />17 <br />19 <br />20 <br />23 <br />25 <br />MINOR w <br />3 <br />5 <br />7 <br />9 <br />W <br />12 <br />14 <br />16 <br />18 <br />21 <br />: yfe-v-1 cf /a Cec / <br />C, be ■ <br />RECHECK'DATST <br />RECEIVED BY: <br />H y. — ///S’cZr^ <br />SA/Jn^RIAN: / J <br />CDI <br />'-I'-C/WZ. - /Jg) <br />li <br />l^L <br />NAME <br />/mA-_______________LOCATION <br />/o/rv <br />MAILING ADDRESS 7 <br />P.O . 60/ CA . <br />OWNER/OPERATOR . ' <br />\fAL sA-A ftSs.o e < <br />PROGRAM/ELEMENT Zz _ n4^ . 33 <br />SMALL WATER SYSTEM OFFICIAL INSPECTION REPORT <br />S JOAQUIN LOCAL HEALTH DISTF T <br />1601 E. HAZbi_iON AVE. STOCKTON, CA 95205 PHvjNE 468-3423 <br />Safety Inadequate <br />SYSTEM STATUS: (MARK ONE) <br />59 60 <br />MAJOR | | <br />DEF. ||