SAN JOAQUIN Environmental Health Department · PDF fileStar Motel 4881 East 11th Street Tracy,...

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SAN JOAQUIN Environmental Health Department Linda Turkatte, REHS, Director COUNTY 1 4k(""V a\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

Transcript of SAN JOAQUIN Environmental Health Department · PDF fileStar Motel 4881 East 11th Street Tracy,...

Page 1: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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

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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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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,

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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

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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.

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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

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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

Page 11: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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le ta

p f

ree

of e

xce

ssiv

e ve

get

atio

n o

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er i

mp

edim

ents

to

sam

ple

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llect

ion?

8.

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e ho

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he ta

p w

as t

rea

ted in

pre

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at io

n fo

r sam

ple

co

llect

ion

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wa

ter,

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bbe

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fect

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flam

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.).

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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 (

rain

y, w

indy

, an

d su

nny

)?

a)

a) F

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Page 13: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

CO

MM

ENTS

z E < ea 1— c

(171 z E < co i— c

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STO

RA

GE

1.

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.

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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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Page 14: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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Page 15: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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

Page 16: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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

Page 17: SAN JOAQUIN Environmental Health Department · PDF fileStar 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

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,,