SAN JOAQUIN Environmental Health Department · PDF fileStar Motel 4881 East 11th Street Tracy,...
Transcript of SAN JOAQUIN Environmental Health Department · PDF fileStar Motel 4881 East 11th Street Tracy,...
SAN JOAQUIN Environmental Health Department Linda Turkatte, REHS, Director
COUNTY
14k(""Va\7- Greatness grows here. Kasey Foley, REHS, Assistant Director
PROGRAM COORDINATORS Robert McClellon, REHS
Jeff Carruesco, REHS, RDI Rodney Estrada, REHS
Willy Ng, REHS Muniappa Naidu, REHS
December 18, 2017
System No. 3900974
Star Motel 4881 East 11th Street Tracy, CA 95376
Water System: Star Motel, 4881 East 1 1 t h Street, Tracy
CITATION NO, 01_69_170_106_3900974_MB TOTAL COLIFORM MAXIMUM CONTAMINANT LEVEL VIOLATION FOR November, 2017
Enclosed is a Citation issued to the Star Motel (hereinafter "Star Motel ") public water system.
The Star Motel will be billed at the San Joaquin County Environmental Health Department's (hereinafter "EHD") hourly rate (currently at $152 per hour) for the time spent on issuing this Citation. California Health and Safety Code, Section 116595, provides that a public water system must reimburse the local primacy agency (EHD) for actual costs incurred by the EHD for specified enforcement actions, including but not limited to, preparing, issuing and monitoring compliance with a citation.
Any person who is aggrieved by a citation issued by the EHD may file a petition with the State Water Resources Control Board (State Water Board) for reconsideration of the citation Petitions must be received by the State Water Board within 30 calendar days of the issuance of the citation. The date of issuance is the date when the EHD mails or serves a copy of the citation, whichever occurs first. If the 30th day falls on a Saturday, Sunday, or state holiday, the petition is due the following business day. Petitions must be received by 5:00 p.m. Information regarding filing petitions may be found at: http://wvvw.waterboards.ca.qov/drinkino water/proqrams/petitionstindex.shtml"
If you have any questions regarding this matter, please contact Vance Wong, Sr. REHS of my staff at [email protected]
Sincerely,
Linda Turkatte, REHS, Director San Joaquin county Environmental Health Department
Enclosures cc: SWRCB — Stockton District, 31 E. Channel Street, Room 270, Stockton CA 95202
1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0208 I vvww.sjcehd.com
Citation No. 01_69_17C_106_3900974_MB
COUNTY OF SAN JOAQUIN
ENVIRONMENTAL HEALTH DEPARTMENT
DRINKING WATER PROGRAM
Name of Public Water System: Star Motel
Water System No: 3900974
Attention: Star Motel 4881 East 11th Street Tracy, CA 95376
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15 Issued: December 18, 2017
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17 CITATION FOR NONCOMPLIANCE
18 TOTAL COLIFORM MAXIMUM CONTAMINANT LEVEL VIOLATION
19 CALIFORNIA CODE OF REGULATIONS, TITLE 22, SECTION 64426.1
20 November, 2017
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22 The California Health and Safety Code (hereinafter "CHSC"), Section 116330
23 allows the State Water Resources Control Board (hereinafter "State Board")
24 to delegate primary responsibility for the administration and enforcement of
25 the Safe Drinking Water Act (hereinafter "SDWA") to the San Joaquin County
26 Environmental Health Department (hereinafter "EHD") for public water
27 systems located in San Joaquin County. CHSC Section 116650 authorizes
28 the EHD to issue a citation to a public water system when the EHD determines
29 that the public water system has violated or is violating the SDWA, (CHSC,
Citation No. 01_69_17C_106_3900974_MB
Division 104, Part 12, Chapter 4, commencing with Section 116270), or any
regulation, standard, permit, or order issued or adopted thereunder.
The EHD hereby issues this citation pursuant to Section 116650 of the CHSC
to the Star Motel Water System (hereinafter "Star Motel") for violation of
CHSC, Section 116555(a)(1) and California Code of Regulations (hereinafter
"CCR"), Title 22, Section 64426.1.
STATEMENT OF FACTS
The Star Motel is classified as a Transient Non-Community water system
serving (2) connection(s) for a population of 25+ customers. The EHD
received laboratory results for (5) bacteriological samples collected during
November, 2017 from the Star Motel. All samples were analyzed for the
presence of total coliform bacteria. (5) of the (5) samples analyzed were
positive for total coliform bacteria. None of the total coliform positive samples
showed the presence of fecal coliform or Escherichia coil (E. coli) bacteria.
DETERMINATION
CCR, Title 22, Section 64426.1, Total Colifornn Maximum Contaminant Level
(MCL) states that a public water system is in violation of the total coliform MCL
if it collects fewer than 40 bacteriological samples per month and if more than
one sample collected during any month is total coliform-positive.
The Star Motel took fewer than 40 bacteriological samples during November,
2017. The results of (1) routine sample(s) and (4) repeat sample(s) were total
coliform positive. Therefore, the EHD has determined that the Star Motel
violated CCR, Title 22, Section 64426.1 during November, 2017.
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Citation No. 01_69_17C_106_3900974_MB
DIRECTIVES
The Star Motel is hereby directed to take the following actions:
1. Comply with CCR, Title 22, Section 64426.1, in all future monitoring
periods.
2. On or before December 28, 2017, notify all persons served by the Star
Motel of the violation of Section 64426.1, in conformance with CCR,
Title 22, Sections 64463.4(b)&(c) and 64465. Appendix 1:
Notification Template shall be used to fulfill this directive, unless
otherwise approved by the EHD.
3. Complete Appendix 2: Compliance Certification Form. Submit it
together with a copy of the public notification to the EHD on or before
December 28, 2017.
4. Submit the information required by CCR, Title 22, Section 64426(b)(2)
on or before December 28, 2017. Appendix 3: Positive Total
Coliform Investigation may be used to fulfill this directive.
5. Pursuant to CCR, Title 22, Section 64424(d), collect and have
analyzed for total coliform bacteria five (5) routine bacteriological
samples on or before December 31, 2017.
6. Pursuant to CCR, Title 22, Section 64469(a), submit analytical results
of all sample analyses completed in a calendar month to the EHD no
later than the tenth day of the following month.
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Citation No. 01_69_170_106_3900974_MB
All submittals required by this Citation shall be submitted to the EHD at the
following address:
San Joaquin County Environmental Health Department
Small Public Water Systems Program
1868 E. HazeIton Avenue
Stockton, CA 95205
Fax: (209) 464-0208
The EHD reserves the right to make such modifications to this Citation as it
may deem necessary to protect public health and safety. Such modifications
may be issued as amendments to this Citation and shall be effective upon
issuance.
Nothing in this Citation relieves the Star Motel of its obligation to meet the
requirements of the California SDWA (CHSC, Division 104, Part 12, Chapter
4, commencing with Section 116270), or any regulation, standard, permit or
order issued or adopted thereunder.
PARTIES BOUND
This Citation shall apply to and be binding upon the Star Motel, its owners,
shareholders, officers, directors, agents, employees, contractors, successors,
and assignees.
SEVERABILITY
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Citation No. 01_69_17C_106_3900974_MB
The directives of this Citation are severable, and the Star Motel shall comply
with each and every provision thereof notwithstanding the effectiveness of
any provision.
FURTHER ENFORCEMENT ACTION
The California SDWA authorizes the EHD to: issue a citation with assessment
of administrative penalties to a public water system for violation or continued
violation of the requirements of the California SDWA or any regulation, permit,
standard, citation, or order issued or adopted thereunder including, but not
limited to, failure to correct a violation identified in a citation or compliance
order. The California SDWA also authorizes the EHD to take action to
suspend or revoke a permit that has been issued to a public water system if
the public water system has violated applicable law or regulations or has failed
to comply with an order of the EHD, and to petition the superior court to take
various enforcement measures against a public water system that has failed
to comply with an order of the EHD. The EHD does not waive any further
enforcement action by issuance of this Citation.
ig,z017
Linda Turkatte, REHS, Director Date
San Joaquin County Environmental Health Department
ppendices (3):
1. Notification Template and Instructions
2. Compliance Certification Form
3. Positive Total Coliform Investigation Report Form
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APPENDIX 1. NOTIFICATION TEMPLATE
Instructions for Tier 2 Unresolved Total Coliform Notice Template
Template Attached
Since exceeding the total coliform bacteria maximum contaminant level is a Tier 2 violation, you must provide public notice to persons served as soon as practical but within 30 days after you learn of the violation [California Code of Regulations, Title 22, Chapter 15, Section 64463.4(b)]. Persistent total coliform problems can be serious. Each water system required to give public notice must submit the notice to the Department for approval prior to distribution or posting, unless otherwise directed by the Department [64463(b)].
Notification Methods
You must use the methods summarized in the table below to deliver the notice to consumers. If you mail, post, or hand deliver, print your notice on letterhead, if available.
If You Are a... You Must Notify Consumers by...
...and By One or More of the Following Methods to Reach Persons Not Likely to be Reached by the Previous Method...
Community Water System [64463.4(c)(1)]
Mail or direct delivery (a) Publication in a local newspaper Posting (b) in public places served by the water system or on the Internet Delivery to community organizations
Non-Community Water System [64463.4(c)(2)]
Posting in conspicuous locations throughout the area served by the water system (b)
Publication in a local newspaper or newsletter distributed to customers Email message to employees or students Posting (b) on the Internet or intranet Direct delivery to each customer
(a) Notice must be distributed to each customer receiving a bill including those that provide their drinking water to others (e.g., schools or school systems, apartment building owners, or large private employers), and other (1) to which water is delivered by the water system.
(b) Notice must be posted in place for as long as the violation or occurrence continues, but in no case less than seven days.
The notice attached is appropriate for the methods described above. However, you may wish to modify it before using it for posting. If you do, you must still include all the required elements and leave the health effects and notification language in italics unchanged. This language is mandatory [64465].
Multilingual Requirement
Spanish. Each public notice must contain information in Spanish regarding (1) the importance of the notice or (2) contain a telephone number or address where Spanish-speaking residents may contact the water system to obtain a translated copy of the public notice or assistance in Spanish.
Non-English Speaking Groups Other than Spanish-Speaking. For each group that exceeds 1,000 residents or 10% of the residents in the community served, whichever is less, the public notice must (1) contain information in the appropriate language(s) regarding the importance of the notice or (2) contain a telephone number or address where such residents may contact the water system to obtain a translated copy of the notice or assistance in the appropriate language.
25-plus Served
If You Take Fewer Than 40 Samples a Month State the number of samples testing positive for coliform. The standard is that no more than one sample per month may be positive.
If You Take 40 or More Samples a Month State the percentage of samples testing positive for coliform. The standard is that no more than 5.0 percent of samples may test positive each month.
APPENDIX 1. NOTIFICATION TEMPLATE
Make sure it is clear who is served by your water system you may need to list the areas you serve.
Description of the Violation
The description of the violation and the MCL vary depending on the number of samples you take. The following table should help you complete the second paragraph of the template.
Corrective Action
In your notice, describe corrective actions you are taking. If you know what is causing the coliform problem, explain this in the notice. Listed below are some steps commonly taken by water systems with a total coliform violation. Use one or more of the following actions, if appropriate, or develop your own:
• "We are chlorinating and flushing the water system." • "We are increasing sampling for coliform bacteria." • "We are investigating the source of contamination." • "We are repairing the wellhead seal." • "We are repairing the storage tank." • "We will inform you when additional samples show no coliform bacteria."
After Issuing the Notice
Send a copy of each type of notice and a certification that you have met all the public notice requirements to the Department within ten days after you issue the notice [64451(d)]. You should also issue a follow-up notice in addition to meeting any repeat notice requirements the Department sets.
It is recommended that you notify health professionals in the area of the violation. People may call their doctors with questions about how the violation may affect their health, and the doctors should have the information they need to respond appropriately.
It is a good idea to issue a "problem corrected" notice when the violation is resolved.
APPENDIX 1. NOTIFICATION TEMPLATE
IMPORTANT INFORMATION ABOUT YOUR DRINKING WATER Este informe contiene inforrnacien muy importante sobre su agua potable.
Tracluzcalo o hable con alguien que lo entienda Nen.
Star Motel Water System Has Levels of Coliform Bacteria Above the Drinking Water Standard During November, 2017
Our water system recently violated a drinking water standard. Although this is not an emergency, as our customers, you have a right to know what you should do, what happened, and what we are doing to correct this situation. We routinely monitor for the presence of drinking water contaminants. We took (5) samples to test for the presence of coliform bacteria during November, 2017. (5) of those samples showed the presence of total coliform bacteria. The standard is that no more than one sample per month may show the presence of coliform bacteria. What should I do?
• You do not need to boil your water or take other corrective actions. If you have other health issues concerning the consumption of this water, you may wish to consult your doctor.
• . If it had been, you would have been notified immediately. Total coliform bacteria are generally not harmful themselves. Coliforms are bacteria which are naturally present in the environment and are used as an indicator that other, potentially-harmful, bacteria may be present. Cot/forms were found in more samples than allowed and this was a warning of potential problems.
• Usually, coliforms are a sign that there could be a problem with the treatment or distribution system (pipes). Whenever we detect coliform bacteria in any sample, we do follow-up testing to see if other bacteria of greater concern, such as fecal coliform or E. coil, are present. We did not find any of these bacteria in our subsequent testing. If we had, we would have notified you immediately. However, we are still finding coliforms in the drinking water.
• People with severely compromised immune systems, infants, and some elderly may be at increased risk. These people should seek advice about drinking water from their health care providers. General guidelines on ways to lessen the risk of infection by microbes are available from U.S. EPA's Safe Drinking Water Hotline at 1(800) 426-4791.
What happened? What is being done? We inspected the well, storage tanks and water lines, which revealed: _
. We will inform you when our sampling shows that
no bacteria are present. We anticipate resolving the problem within . For more information,
please contact at or
Please share this information with all the other people who drink this water, especially those who may not have received this notice directly (for example, people in apartments, nursing homes, schools, and businesses). You can do this by posting this public notice in a public place or distributing copies by hand or mail. Secondary Notification Requirements: Upon receipt of notification from a person operating a public water system, the following notification must be given within 10 days [Health and Safety Code Section 116450(g)]:
• SCHOOLS: Must notify school employees, students, and parents (if the students are minors). • RESIDENTIAL RENTAL PROPERTY OWNERS OR MANAGERS (including nursing homes and care facilities): Must notify
tenants. • BUSINESS PROPERTY OWNERS, MANAGERS, OR OPERATORS: Must notify employees of businesses located on the
property.
I (We) declare under penalty of perjury that the statements on this application are correct to my (our) knowledge and the actions taken to notify the users of this water system are in compliance with California Code of Regulations (CCR), for exceeding the Maximum Contaminant Level for Total Coliform bacteria.
This notice is being sent to you by . Signature:
Please fax completed form to: (209) 464-0208, Attn: SPWS Program.
This is not an emergencV
APPENDIX 2. COMPLIANCE TEMPLATE
Citation Number: 01_69_17C_106_3900974_MB
Name of Water System: Star Motel
System Number: 3900974
Certification
I certify that the users of the water supplied by this water system were notified of the
bacteriological violation of California Code of Regulations, Title 22, Section 64426.1 for the
compliance period of November, 2017 and that public notification was completed on
(date completed)
Signature of Water System Representative Date
Attach a copy of the public notice distributed to the water system's customers
THIS FORM MUST BE COMPLETED AND RETURNED TO THE END, SPWS PROGRAM, NO LATER THAN DECEMBER 28, 2017
Disclosure: Be advised that the California Health and Safety Code, Sections 116725 and 116730 state that any person who knowingly makes any false statement on any report or document submitted for the purpose of compliance with the Safe Drinking Water Act may be liable for, respectively, a civil penalty not to exceed five thousand dollars ($5,000) for each separate violation or, for continuing violations, for each day that violation continues, or be punished by a fine of not more than $25,000 for each day of violation, or by imprisonment in the county jail not to exceed one year, or by both the fine and imprisonment.
Please fax completed form to: (209) 464-0208, Attn: SPWS Program
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ons
to t
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aw
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ns?
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crib
e a
ll co
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h.
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ellh
ead
secu
red
to p
reve
nt u
nau
thor
ized
acc
ess? i.
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wha
t tre
atm
ent p
lant
(na
me)
doe
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his
we
ll pu
mp? j.
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oft
en a
re r
aw w
ate
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tal c
olif
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amp
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take
n an
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st T
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st a
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cati
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nsp
ect a
nd
rev
iew
rec
ords
for
sur
face
wa
ter s
ourc
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f app
licab
le)
a.
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e t
here
bee
n a
ny e
ven
ts i
n th
e w
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rshe
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r th
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ve c
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Is th
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mp
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p lo
cated in
an
exte
rior
loc
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tec
ted
by a
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ple
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ave
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inks
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Is
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tap i
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cond
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f lea
ks a
roun
d th
e st
em o
r pa
cki
ng?
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n th
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mp
le ta
p b
e a
djus
ted
to t
he p
oin
t whe
re a
goo
d la
min
ar f
low
can
be
ac
hie v
ed w
ithou
t exc
ess
ive
spla
sh?
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mp
le ta
p a
nd a
reas
ar
oun
d th
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amp
le ta
p c
lean
and
dry
(fre
e of
ani
mal
dr
opp
ings
oth
er c
ont
amin
ants
or s
pra
y ir
rigat
ion
syst
ems
) ?
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the
are
a ar
oun
d th
e sa
mp
le ta
p f
ree
of e
xce
ssiv
e ve
get
atio
n o
r oth
er i
mp
edim
ents
to
sam
ple
co
llect
ion?
8.
Des
crib
e ho
w t
he ta
p w
as t
rea
ted in
pre
par
at io
n fo
r sam
ple
co
llect
ion
(ran
wa
ter,
swa
bbe
d w
ith d
isin
fect
ant,
flam
ed,
etc
.).
9.
Is th
is s
am
ple
tap
des
igna
ted
on t
he s
amp
ling
pla
n su
bmitt
ed w
ith thi
s in
form
atio
n re
que
st?
10.
Wha
t wer
e th
e w
eath
er c
ondi
t ions
at t
he t
ime
of th
e p
ositi
ve s
amp
le (
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Is e
ach
tank
lock
ed to
pre
ven
t una
uth
oriz
ed a
cces
s?
2.
Are
all
vent
s of
eac
h ta
nk
scre
ene
d do
wn-
turn
ed to
pre
ven
t dus
t an
d di
rt fr
om
ente
ring
the
tan
k?
3.
Is t
he o
verf
low
on
eac
h ta
nk
scre
ene
d?
4.
Are
the
re a
ny u
nsea
led
open
ings
in
the
tank
suc
h as
acc
ess
doo
rs,
wa
ter
leve
l in
dica
tors
ha
tche
s, e
tc.?
5.
Is t
he r
oof/c
over
of th
e ta
nk
sea
led
and
free
of a
ny le
aks?
6.
Is t
he ta
nk
abov
e g
roun
d or
bur
ied?
a.
If bu
ried
or
part
ially
bur
ied,
are
the
re p
rovi
sion
s to
dir
ect s
urfa
ce w
ate
r aw
ay f
rom
th
e si
te.
b.
Has
the
inte
rior
of t
he t
ank
been
insp
ecte
d to
ide
ntify
any
san
itary
de
fect
s, s
uch
as r
oot i
ntru
sion
?
8.
Doe
s th
e ta
nk "f
loat
" on
the
dis
trib
utio
n sy
stem
or a
re t
here
sep
ara
te in
let a
nd
outl
et
lines
?
9.
Wha
t is
the
mea
sure
d ch
lori
ne re
sid
ual (
tota
l/fre
e) o
f th
e w
ate
r ex
iting
the
sto
rag
e ta
nk to
day?
10.
Wha
t is
the
volu
me
of t
he s
tora
ge
tank
in g
allo
ns?
11.
Is t
he ta
nk
baff
led?
12.
Prio
r to
the
TC
+ or
EC
+, w
hat w
as t
he p
revi
ous
date
item
#1-
7 w
ere
chec
ked
and
docu
men
ted?
SY
STEM
RES
PON
SES
i
DIS
TRIB
UT
ION
SYST
EM
1.
Wha
t is
the
min
imum
pre
ssur
e y
ou a
re m
ain
tain
ing
in t
he d
istr
ibu t
ion
syst
em?
2.
Did
pre
ssur
e in
the
dis
trib
utio
n sy
stem
dro
p to
les
s th
an 5
psi
pri
or to
pos
itive
bacti?
3.
Has
the
dis
trib
u tio
n sy
stem
bee
n w
orke
d on
with
in th
e la
st w
eek?
(ta
ps,
hyd
ran
t flu
shin
g,
mai
n br
eaks
, ma
inlin
e ex
tens
ions
, etc
.) I
f yes
, p
rovid
e det
ails
. 4.
Are
the
re a
ny s
igns
of e
xcav
atio
ns n
ear y
our di
s trib
u tio
n sy
stem
no
t un
der
the
dire
ct
cont
rol o
f you
r ma
inte
nanc
e s
taff?
5.
Did
you
insp
ect y
our
dis tr
ibu tio
n sy
stem
to
che
ck fo
r ma
inlin
e le
aks
? D
o yo
u or
did
you
ha
ve a
ma
inlin
e le
ak?
6.
If th
ere
was
a m
ain
line
lea
k, w
hen
was
it r
epai
red?
7.
On
wha
t da
te w
as t
he d
istr
ibu t
ion
syst
em l
ast f
lush
ed?
r 8. I
s th
ere
a w
ritte
n flu
shin
g p
roce
dure
you
can
pro
vide
for
our
rev
iew? -
-
9.
Do
you
have
an
ac
tive
cros
s-co
nnec
tion
con
trol p
rogr
am?
10.
Wha
t is n
am
e &
pho
ne n
umbe
r o
f you
r C
ross
-Con
nec
tion
Co
ntro
l Pro
gra
m C
oord
inat
or?
11.
Is th
e re
vie
w a
nd te
stin
g of
bac
kflo
w p
reve
ntio
n de
vic
es c
urre
nt?
12.
On
what da
te w
as t
he la
st p
hysi
cal s
urve
y o
f the
sy
stem
don
e to
ide
ntif
y cr
oss-
conn
ectio
ns?
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464
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8, A
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SPW
S Pr
ogra
m
est LABORATORIES,INC,
SYSTEM # 3900974
SAMPLE TYPE
RESID CL2
TOTAL COLIFORM BAC FERIA (MPN/100mL)
E. COLT COLIFORM BACTERIA (M1PN/100mL)
3A N/A PRESENCE ABSENCE
SAMPLE ADDRESS; SAME
F COLL WL#
1210 V278 ROOM # 101
TIME SAMPLE LOCATION
COPY TO: SAN JOAQUIN CO.
FAX TO:
EMAIL TO:
ID#: C260
STAR MOTEL
4881 EAST 11TH ST.
TRACY, CA 95176
ATTN: MR, PANCHAL
P. O. Box 355 6602 2nd Street Riverbank, CA 95367
Phone 209-869-9260 Fax 209-869-2278 State Certification #1310
COLLECTED BY: P. DELANO
DATE COLLECTED: 11/27/2017
DATE/TIME RECEIVED: 11/27/2017 / 1450
DATE/TIME STARTED: 11/27/2017 / 1615
DATE/TIME COMPLETED: 11/28/2017 1 1630
DATE REPORTED: 11/29/2017
BACTERIOLOGICAL TEST FOR COLIFORM BACTERIA IN DRINKING WATER STD. METHODS #9223
CERTIFICATE OF ANALYSIS
IF ANY SAMPLE INDICATES AN "ABSENCE" OF TOTAL COLIFORM BACTERIA, IT MEETS STATE STANDARDS FOR COLIFORM BACTERIA.
IF ANY SAMPLE INDICATES A "PRESENCE" OF TOTAL COLIFORM BACTERIA, IT DOES NOT MEET STATE STANDARDS FOR COLIFORM BACTERIA.
SAMPLE TYPE: 1 - WELL 2- WELL TANK 3- DISTRIBUTION SYSTEM 4- SURFACE WATER/ SOURCE 5- OTHER
PERSON NOTIFIED: AKSHAY
DATE/TIME NOTIFIED: 11-28-17
REASON FOR TEST: A - ROUTINE B - REPEAT C - SPECIAL
SIGNATURE. ABORATORY DIRECTOR Di
I
REASON FOR TEST: A - ROUTINE B - REPEAT C - SPECIAL
SIGNATURE.
R 0. Box 355 6602 2nd Street Riverbank, CA 95367 COPY TO: SAN JOAQLTIN CO.
FAX TO;
EMAIL TO:
Phone 209-869-9260 Fax 209-869-2278 State Certification #1310
LABORATORIES,INC.
Ii
Mit C260
STAR MOTEL COLLECTED BY: P. DELANO 4881 EAST 11TH ST. DATE COLLECTED: 11/29/2017 TRACY, CA 95376 DATE/TIME RECEIVED: 11/29/2017 / 1630
DATE/TIME STARTED: 11/29/2017 / 1630 ATTN: MR. PANCHAL DATE/TIME COMPLETED: 1 1/30/2017 / 1700
DATE REPORTED: 12/1/2017
BACTERIOLOGICAL TEST FOR COLIFORM BACTERIA IN DRINKING WATER STD. METHODS #9223
CERTIFICATE OF ANALYSIS
SAMPLE ADDRESS: SAME SYSTEM # 3900974
TIME TOTAL E. COLT COLL FWL# SAMPLE
LOCATION SAMPLE TYPE
RESID CL2
COLIFORM BACTERIA
COLIFORM BACTERIA
(MPN/100mL) (MPN/100mL) 0920 W280 ROOM # 101 313 <0.05 PRESENCE (76.6) ABSENCE (<1.0) 0930 X280 MANAGER'S OFFICE 313 <0.05 PRESENCE (85.5) ABSENCE (<1.0) 0940 Y280 HB NEAR WELL TANK 3B <0.05 PRESENCE (40.4) ABSENCE (<1.0) 0950 Z280 WELL 113 <0.05 PRESENCE (34.5) ABSENCE (<1.0)
IF ANY SAMPLE INDICATES AN "ABSENCE" OF TOTAL COLIFORM BACTERIA, IT MEETS STATE STANDARDS FOR COLIFORM BACTERIA.
IF ANY SAMPLE INDICATES A "PRESENCE" OF TOTAL COLIFORM BACTERIA, IT DOES NOT MEET STATE STANDARDS FOR COLIFORM BACTERIA.
SAMPLE TYPE: I - WELL 2- WELL TANK 3 - DISTRIBUTION SYSTEM 4- SURFACE WATER/ SOURCE 5 - OTHER
PERSON NOTIFIED: AKSHAY
DATEMME NOTIFIED: 11-30-17
4r West \LABORATORIES,INC
P. 0. Box 355 6602 2nd Street Riverbank, CA 95367 COPY TO: SAN JOAQUIN CO.
FAX TO:
EMAIL TO:
Phone 209-869-9260 Fax 209-869-2278 State Certification #1310
ID#: C260
STAR MOTEL COLLECTED BY: S. HEDGE 4881 EAST 11TH ST. DATE COLLECTED: 12/8/2017 TRACY, CA 95376 DATE/TIME RECEIVED: 12/9/2017 / 1030
DATE/TIME STARTED: 12/9/2017 / 1030 ATTN: MR. PANCHAL DATE/TIME COMPLETED: 12/10/2017 / 1030
DATE REPORTED: 12/11/2017
BACTERIOLOGICAL TEST FOR COLIFORM BACTERIA IN DRINKING WATER STD. METHODS #9223
CERTIFICATE OF ANALYSIS
SAMPLE ADDRESS: SAME SYSTEM # 3900974
TIME TOTAL E. COLI COLL FWL# SAMPLE SAMPLE RESID COLIFORM COLIFORM
LOCATION TYPE CL2 BACTERIA BACTERIA (MPN/100mL) (MPN/100mL)
1410 8289 ROOM # 101 3A <0.05 ABSENCE (<1.0) ABSENCE (<1.0) 1417 C289 MAIN OFFICE 3A <0.05 PRESENCE (248.1) ABSENCE (<1.0) 1424 D289 HOSEBIB NEAR WELL TANK 3A <0.05 PRESENCE (387.3) ABSENCE (<1.0) 1436 E289 WELL 1A <0.05 PRESENCE (770.1) ABSENCE (<1.0)
IF ANY SAMPLE INDICATES AN "ABSENCE" OF TOTAL COLIFORM BACTERIA, IT MEETS STATE STANDARDS FOR COLIFORM BACTERIA.
IF ANY SAMPLE INDICATES A "PRESENCE" OF TOTAL COLIFORM BACTERIA, IT DOES NOT MEET STATE STANDARDS FOR COLIFORM BACTERIA.
SAMPLE TYPE: 1 - WELL 2- WELL TANK 3- DISTRIBUTION SYSTEM 4- SURFACE WATER/ SOURCE 5- OTHER
REASON FOR. TEST: A ROUTINE B - REPEAT C - SPECIAL
SIGNATURE. i§
PERSON NOTIFIED: SAM HEDGE
DATE/TIME NOTIFIED: 12-10-17
LABORATORY DIRECTOR/76,,