{\rtf1\ansi {\colortbl;\red0\green0\blue0;\red0\green0\blue255;\red0\green255\blue255;\red0\green255\blue0;\red255\green0\blue255;\red255\green0\blue0;\red255\green255\blue0;\red255\green255\blue255;\red51\green51\blue51;\red127\green154\blue213;\red52\green52\blue52;}{\fonttbl{\f0\froman\cpg0\fcharset0 Times New Roman;}{\f1\froman\cpg1252\fcharset0 Times New Roman;}{\f2\froman\cpg1251\fcharset204 Times New Roman;}{\f3\froman\cpg1250\fcharset238 Times New Roman;}{\f4\froman\cpg1257\fcharset186 Times New Roman;}{\f5\froman\cpg1254\fcharset162 Times New Roman;}{\f6\froman\cpg1253\fcharset161 Times New Roman;}{\f7\froman\cpg1255\fcharset177 Times New Roman;}{\f8\froman\cpg0\fcharset161 Times New Roman;}{\f9\fswiss\cpg0\fcharset0 Arial;}{\f10\fswiss\cpg1252\fcharset0 Arial;}{\f11\fswiss\cpg1251\fcharset204 Arial;}{\f12\fswiss\cpg1250\fcharset238 Arial;}{\f13\fswiss\cpg1257\fcharset186 Arial;}{\f14\fswiss\cpg1254\fcharset162 Arial;}{\f15\fswiss\cpg1253\fcharset161 Arial;}{\f16\fswiss\cpg1255\fcharset177 Arial;}{\f17\fswiss\cpg0\fcharset161 Arial;}}{\stylesheet {\sbasedon222\f1\fs20 Normal;}}\paperw12240\paperh15840\margl1145\margr1034\margt360\margb360 \sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1145\margrsxn1034\margtsxn360\margbsxn360\cols1\colsx60 \pard \plain \cbpat8\qr\li0\fi0\ri77\sb0\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw2\f1\cchs0\lang1033\fs24 Page 1 of3}\par \pard \plain \cbpat8\ql\li43\fi0\ri0\sb782\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-29\f1\cchs0\lang1033\fs24 DRAFT}\par \pard \plain \cbpat8\ql\li58\fi0\ri0\sb221\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs23 18. LEAD SERVICE LINE REPLACEMENT}\par \pard \plain \cbpat8\ql\li43\fi0\ri0\sb1315\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-3\f1\cchs0\lang1033\fs20 ONLY FOR COMMUNITY WATER SYSTEMS}\par \pard \plain \cbpat8\ql\li48\fi0\ri0\sb197\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Your water system classification is: Community Water System j}\par \pard \plain \cbpat8\ql\li48\fi0\ri0\sb187\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Section 116885 of the California Health and Safety Code. Lead Service Lines in Public Water Systems, added to the Health \expndtw-2 and Safety Code by Senate Bill 1398 (2016) and amended by Senate Bill 427 (2017), requires all community water systems \expndtw0 (CWS) to compile an inventory of known partial or total lead user service lines in use in its distribution system by July 1, \expndtw-1 2018. The inventory must include all user service lines that are active and those that are reasonably expected to become \expndtw0 active in the future. Also, Section 116885 requires that CWS identify areas that may have lead user service lines in use, and/or identify any areas within the CWS distribution system that the CWS cannot identify the material that is being used \expndtw-1 for the service line.}\par \pard \plain \cbpat8\ql\li62\fi0\ri0\sb192\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 For additional information, please visit}\par \pard \plain \cbpat8\ql\li58\fi0\ri0\sb0\sa0 \f1\fs20{\b0\i0\ul\cf10\charscalex100\expndtw2\f1\cchs0\lang1033\fs20 https://www.waterboards.ca.gov/drinking water/certlic/drinkingwater/lead service line inventory pws.html}\par \pard \plain \cbpat8\ql\li62\fi0\ri0\sb192\sa0\sl-245\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 If you have questions about completing this section of the report, please contact David.Pimentel@Waterboards.ca.gov or call (916) 323-0572.}\par \pard \plain \cbpat8\ql\li106\fi0\ri0\sb226\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Date lead service line inventory was completed (MM/DD/YYYYV}\par \pard \plain \cbpat8\ql\li67\fi0\ri0\sb274\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw0\f1\cchs0\lang1033\fs23 A. User service line inventory:}\par \pard \plain \cbpat8\ql\li77\fi0\ri0\sb221\sa288\sl-240\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 "\super T\nosupersub Jser service line" means the oipe, tubing, and fittings connecting a water main to an individual water meter or service connection.}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn3142\margrsxn1240\margtsxn360\margbsxn360\cols3\colno1\colw1161\colsr2174\colno2\colw1848\colsr422\colno3\colw2251 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb259\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 Pipe Material}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb10\sa0\sl-230\slmult0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Estimated Number \b0 of}\par \pard \plain \cbpat8\ql\li168\fi206\ri0\sb0\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 Service Lines \expndtw-1 (Enter "0" if none)}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0\sl-235\slmult0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Estimated Total Length \b0 of}\par \pard \plain \cbpat8\ql\li230\fi346\ri0\sb0\sa0\sl-235\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Service Lines \b (In feet), \b0 if applicable}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1299\margrsxn1696\margtsxn360\margbsxn360\cols1\colsx60  \pard\plain \sb149\sa0\fs2\par\sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1299\margrsxn1696\margtsxn360\margbsxn360\cols3\colno1\colw720\colsr5333\colno2\colw720\colsr1752\colno3\colw720 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-4\f1\cchs0\lang1033\fs20 A. Lead}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb14\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f10\cchs0\lang1033\fs18 0}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb10\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f10\cchs0\lang1033\fs18 0}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1145\margrsxn1034\margtsxn360\margbsxn360\cols1\colsx60 \pard \plain \cbpat8\ql\li154\fi0\ri0\sb134\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 B. Unknown material}\par \pard \plain \cbpat8\ql\li149\fi0\ri0\sb134\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 C. Copper}\par \pard \plain \cbpat8\ql\li163\fi0\ri0\sb139\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 D. Cast iron (ductile pipe)}\par \pard \plain \cbpat8\ql\li158\fi0\ri0\sb130\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 E. Ductile iron}\par \pard \plain \cbpat8\ql\li163\fi0\ri0\sb144\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 F. Galvanized steel}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb134\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-4\f1\cchs0\lang1033\fs20 G. Poly vinyl chloride (PVC)}\par \pard \plain \cbpat8\ql\li163\fi0\ri0\sb144\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 H. Polyethylene (PE)}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb130\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 I. High density polyethylene (HOPE)}\par \pard \plain \cbpat8\ql\li163\fi0\ri0\sb134\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 J. Polybutylene (PB)}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb139\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 K. Transite/asbestos cement}\par \pard \plain \cbpat8\ql\li173\fi0\ri0\sb134\sa0 \f1\fs20{\b\i0\ul\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 L. Other materials not listed above:}\par \pard \plain \cbpat8\ql\li178\fi0\ri0\sb134\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-3\f1\cchs0\lang1033\fs20 Identify material 1}\par \pard \plain \cbpat8\ql\li0\fi0\ri0\sb442\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-1\f1\cchs0\lang1033\fs24 https://drinc.ca.gov/ear/PWSEarReport.aspx?SurveyID=20&PwsID=CA3200114&printabl...   6/20/2018}\par \sect\sectd \sbkpage\pgwsxn12240\pghsxn15840\marglsxn1138\margrsxn1036\margtsxn360\margbsxn360\cols1\colsx60 \pard \plain \cbpat8\qr\li0\fi0\ri62\sb0\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-2\f1\cchs0\lang1033\fs25 Page 1 of3}\par \pard \plain \cbpat8\ql\li58\fi0\ri0\sb797\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-8\f1\cchs0\lang1033\fs21 DRAFT}\par \pard \plain \cbpat8\ql\li82\fi0\ri0\sb235\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs23 18. LEAD SERVICE LINE REPLACEMENT}\par \pard \plain \cbpat8\ql\li58\fi0\ri0\sb1315\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-3\f1\cchs0\lang1033\fs20 ONLY FOR COMMUNITY WATER SYSTEMS}\par \pard \plain \cbpat8\ql\li62\fi0\ri0\sb187\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Your water system classification is: Community Water System}\par \pard \plain \cbpat8\ql\li62\fi0\ri0\sb192\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Section 116885 of the California Health and Safety Code. Lead Service Lines in Public Water Systems, added to the Health and Safety Code by Senate Bill 1398 (2016) and amended by Senate Bill 427 (2017), requires all community water systems \expndtw-4 (CWS) to compile an inventory of known partial or total lead user service lines in use in its distribution system by July 1, 2018. The inventory must include all user service lines that are active and those that are reasonably expected to become active in the future. Also, Section 116885 requires that CWS identify areas that may have lead user service lines in use, and/or identify any areas within the CWS distribution system that the CWS cannot identify the material that is being used \expndtw-5 for the service line.}\par \pard \plain \cbpat8\ql\li67\fi0\ri0\sb187\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-4\f1\cchs0\lang1033\fs21 For additional information, please visit}\par \pard \plain \cbpat8\ql\li67\fi0\ri0\sb0\sa0 \f1\fs20{\b0\i0\ul\cf10\charscalex100\expndtw-2\f1\cchs0\lang1033\fs21 https://www.waterboards.ca.gov/drinking water/certlic/drinkingwater/lead service line inventory pws.html}\par \pard \plain \cbpat8\ql\li72\fi0\ri0\sb192\sa0\sl-235\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 If you have questions about completing this section of the report, please contact David.Pimentel@Waterboards.ca.gov or \expndtw-5 call (916) 323-0572.}\par \pard \plain \cbpat8\ql\li115\fi0\ri0\sb226\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Date lead service line inventory was completed (MM/DD/YYYY1'}\par \pard \plain \cbpat8\ql\li77\fi0\ri0\sb274\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw0\f1\cchs0\lang1033\fs23 A. User service line inventory:}\par \pard \plain \cbpat8\ql\li86\fi0\ri0\sb226\sa307\sl-235\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 '"Jser service line" means the oipe, tubing, and fittings connecting a water main to an individual water meter or service \expndtw-7 connection.}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1138\margrsxn1036\margtsxn360\margbsxn360\cols1\colsx60  \pard\plain \sb0\sa0\brdrt\brdrs\brdrw20\brsp20\fs2\par\sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn3145\margrsxn1238\margtsxn360\margbsxn360\cols3\colno1\colw1152\colsr2189\colno2\colw1843\colsr427\colno3\colw2246 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb240\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-3\f1\cchs0\lang1033\fs20 Pipe Material}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0\sl-230\slmult0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Estimated Number \b0 of}\par \pard \plain \cbpat8\ql\li158\fi206\ri0\sb0\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Service Lines \expndtw-5 (Enter "0" if none)}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0\sl-230\slmult0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-1\f1\cchs0\lang1033\fs20 Estimated Total Length \b0 of}\par \pard \plain \cbpat8\ql\li221\fi346\ri0\sb0\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Service Lines \b\expndtw-5 (In feet), \b0 if applicable}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1297\margrsxn1699\margtsxn360\margbsxn360\cols1\colsx60  \pard\plain \sb134\sa0\fs2\par\sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1297\margrsxn1699\margtsxn360\margbsxn360\cols3\colno1\colw720\colsr5333\colno2\colw720\colsr1752\colno3\colw720 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-3\f1\cchs0\lang1033\fs20 A. Lead}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb24\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f10\cchs0\lang1033\fs17 0}\par \column \pard \plain \cbpat8\ql\li0\fi0\ri0\sb24\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f10\cchs0\lang1033\fs17 0}\par \sect\sectd \sbknone\pgwsxn12240\pghsxn15840\marglsxn1138\margrsxn1036\margtsxn360\margbsxn360\cols1\colsx60 \pard \plain \cbpat8\ql\li163\fi0\ri0\sb139\sa0 \f1\fs20{\b\i0\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 B. Unknown material}\par \pard \plain \cbpat8\ql\li154\fi0\ri0\sb120\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 C. Copper}\par \pard \plain \cbpat8\ql\li158\fi0\ri0\sb134\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 D. Cast iron (ductile pipe)}\par \pard \plain \cbpat8\ql\li163\fi0\ri0\sb125\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 E. Ductile iron}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb130\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 F. Galvanized steel}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb125\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 G. Polyvinyl chloride (PVC)}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb125\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 H. Polyethylene (PE)}\par \pard \plain \cbpat8\ql\li178\fi0\ri0\sb130\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 I. High density polyethylene (HOPE)}\par \pard \plain \cbpat8\ql\li168\fi0\ri0\sb125\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 J. Polybutylene (PB)}\par \pard \plain \cbpat8\ql\li173\fi0\ri0\sb130\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 K. Transite/asbestos cement}\par \pard \plain \cbpat8\ql\li178\fi0\ri0\sb130\sa0 \f1\fs20{\b\i0\ul\cf9\charscalex100\expndtw-2\f1\cchs0\lang1033\fs20 L. Other materials not listed above:}\par \pard \plain \cbpat8\ql\li173\fi0\ri0\sb125\sa0 \f1\fs20{\b0\i0\cf9\charscalex100\expndtw-7\f1\cchs0\lang1033\fs21 Identify material 1}\par \pard \plain \cbpat8\ql\li0\fi0\ri0\sb432\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs25 https://drinc.ca.gov/ear/PWSEarReport.aspx?SurveyID=20&PwsID=CA3200114&printabl...   6/20/2018}\par \sect\sectd \sbkpage\pgwsxn12240\pghsxn15840\marglsxn1133\margrsxn1042\margtsxn360\margbsxn360\cols1\colsx60 \pard \plain \cbpat8\qr\li0\fi0\ri53\sb0\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-7\f1\cchs0\lang1033\fs25 Page 2 of 3}\par \pard\plain\fs2\sa658\par\trowd\trgaph40 \trrh-346 \clvertalt\clcbpat8\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx4474 \clvertalt\clcbpat8\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Identify material 2}\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard\intbl\row \trowd\trgaph40 \trrh-365 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx4474 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Identify material 3}\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard\intbl\row \trowd\trgaph40 \trrh-365 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx4474 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Identify material 4}\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard\intbl\row \trowd\trgaph40 \trrh-365 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Total number of service lines inventoried* (calculated field)}\cell \pard \plain \cbpat8\ql\li998\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 0}\cell \pard\intbl\row \trowd\trgaph40 \trrh-595 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi-5\ri168\sb0\sa0\sl-230\slmult0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Total number of service connections from Section 3 of the \expndtw-7 EAR}\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard\intbl\row \trowd\trgaph40 \trrh-365 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf11\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 Fittings or fittings connecting a water main:}\cell \pard\intbl\row \trowd\trgaph40 \trrh-278 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\cltxlrtb\cellx4474 \clvmgf\clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvmgf\clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 M. Lead fittings NOT on a lead pipe(e.g., goosenecks.}\cell \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20\cell \pard \plain \cbpat8\ql\li1008\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 0}\cell \pard\intbl\row \trowd\trgaph40 \trrh-326 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\cltxlrtb\cellx4474 \clvmrg\clvertalt\clcbpat8\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvmrg\clvertalt\clcbpat8\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 pigtails, and corporation stops)}\cell {\par \cell }{\par \cell }\pard\intbl\row \trowd\trgaph40 \trrh-595 \clvertalc\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalc\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi-5\ri158\sb0\sa0\sl-230\slmult0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 N. \ul Lead fittings ON\ul0  a lead pipe (e.g., goosenecks, pigtails, and corporation stops)}\cell \pard \plain \cbpat8\ql\li1013\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 0}\cell \pard\intbl\row \trowd\trgaph40 \trrh-595 \clvertalc\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalc\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi5\ri106\sb0\sa0\sl-235\slmult0 \intbl \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 O. \ul Fittings of unknown material\ul0  (e.g., goosenecks, pigtails, \expndtw-5 and corporation stops)}\cell \pard \plain \cbpat8\ql\li1013\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 0}\cell \pard\intbl\row \trowd\trgaph40 \trrh-394 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx5012 \clvertalt\clcbpat8\clbrdrt\brdrs\brdrw15\clbrdrl\brdrs\brdrw15\clbrdrb\brdrs\brdrw15\clbrdrr\brdrs\brdrw15\cltxlrtb\cellx7383 \pard \plain \cbpat8\ql\li0\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-3\f1\cchs0\lang1033\fs21 Total number of lead service lines** (calculated field)}\cell \pard \plain \cbpat8\ql\li1018\fi0\ri0\sb0\sa0 \intbl \f1\fs20{\b0\i0\cf1\charscalex100\expndtw0\f1\cchs0\lang1033\fs21 0}\cell \pard\intbl\row \pard\pard \plain \cbpat8\ql\li86\fi0\ri3072\sb14\sa0\sl-432\slmult0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 *Total number of service lines inventoried (calculated field) = Sum of A through L \expndtw-5 **Total number of lead service lines (calculated field) = Sum of A and M To Update calculated field, click button below}\par \pard \plain \cbpat8\ql\li221\fi0\ri0\sb206\sa0 \f1\fs20{\b0\i0\cf1\charscalex100\expndtw-3\f10\cchs0\lang1033\fs17 To update totals click here}\par \pard \plain \cbpat8\ql\li86\fi0\ri0\sb278\sa0\tx355 \f1\fs20{\b\i0\cf11\charscalex100\expndtw-8\f1\cchs0\lang1033\fs23 B.{\charscalex100\expndtw0\tab }\expndtw1 Method(s) used to prepare the lead service line inventory in Part A (check all that apply):}\par \pard \plain \cbpat8\ql\li336\fi0\ri0\sb245\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Tap Cards or tickets from initial service installation}\par \pard \plain \cbpat8\ql\li341\fi0\ri0\sb0\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Plans from water main installation, rehabilitation, and replacement}\par \pard \plain \cbpat8\ql\li336\fi0\ri0\sb0\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Records indicating when buildings were constructed}\par \pard \plain \cbpat8\ql\li134\fi206\ri384\sb0\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Meter replacement records \expndtw-6\loch\af0\hich\af0\dbch\f1\cchs0 \'95\hich\af0\dbch\af1\loch\f0\cchs0 ^ Distribution maps, drawings, or GIS \expndtw-5 D Visual confirmation of pipe material by plumbers or utility crews during maintenance or installation activities}\par \pard \plain \cbpat8\ql\li154\fi192\ri4608\sb0\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-6\f1\cchs0\lang1033\fs21 Interviews with water system personnel and/or past employees \expndtw-3 ^ Field investigations}\par \pard \plain \cbpat8\ql\li336\fi0\ri0\sb0\sa0\sl-250\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Other (describe below):}\par \pard \plain \cbpat8\ql\li86\fi0\ri0\sb456\sa0\tx355 \f1\fs20{\b\i0\cf11\charscalex100\expndtw-9\f1\cchs0\lang1033\fs23 C.{\charscalex100\expndtw0\tab }\expndtw1 PRINT THIS INVENTORY FORM FOR YOUR SIGNATURE}\par \pard \plain \cbpat8\ql\li96\fi0\ri384\sb235\sa0\sl-230\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 I certify under penalty of perjury under the laws of the State of California that the foregoing [including any uploaded documents] is true and correct to the best of my knowledge.}\par \pard \plain \cbpat8\ql\li125\fi0\ri4608\sb192\sa0\sl-278\slmult0\tx2630 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-8\f1\cchs0\lang1033\fs21 Signatures-\line \expndtw-9 Name:{\charscalex100\expndtw0\tab }\expndtw-6 David Saltel\line \expndtw-8 Title:{\charscalex100\expndtw0\tab }\expndtw-7 Owner\line \expndtw-3 Phone number{\charscalex100\expndtw0\tab }\expndtw-6 (916)425-9489\line Date signed (MM/DD/YYYY): 06/20/2018\line \expndtw-10 PWS Name:{\charscalex100\expndtw0\tab }\expndtw-9 EVERGREEN MOTEL & MHP\line \expndtw-3 PWSNo.:{\charscalex100\expndtw0\tab }\expndtw-7 CA3200114}\par \pard \plain \cbpat8\ql\li96\fi0\ri2304\sb226\sa0\sl-226\slmult0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-5\f1\cchs0\lang1033\fs21 Print this completed form by clicking "Print" below, sign and scan. This is your certified form. Print}\par \pard \plain \cbpat8\ql\li0\fi0\ri0\sb226\sa0 \f1\fs20{\b0\i0\cf11\charscalex100\expndtw-6\f1\cchs0\lang1033\fs25 https://drinc.ca.gov/ear/PWSEarReport.aspx?SurveyID=20&PwsID=CA3200114&printabl...   6/20/2018}\par }