Item5_CC-Staff-Report-Cross-Connection-Ordinance-26-xx-20260210 — Grover Beach City Council, February 10, 2026

CITY OF GROVER BEACH

CITY COUNCIL STAFF REPORT
Agenda Item No. 5
Placement: Consent
Meeting Date: February 10, 2026
TO: Honorable Mayor and City Council
FROM: Matthew Bronson, City Manager
PREPARED BY: Greg Ray, Public Works Director
Billy Haas, Public Works Superintendent
SUBJECT: Introduction and First Reading of an Ordinance Amending Chapter 50 (Water) of Title V (Public Works) of the Grover Beach Municipal Code to Add Sections 50.030 through 50.039 pertaining to Cross Connection Controls and Inspections

RECOMMENDATION
Introduce and conduct the first reading, by title only, of an Ordinance to Amend Chapter 50 (Water) of Title V (Public Works) of the Grover Beach Municipal Code (GBMC) to add sections

50.030 through 50.039 pertaining to Cross Connection Controls and inspections and schedule the second reading, public hearing and adoption of the Ordinance for the next regularly scheduled meeting.

BACKGROUND
A cross-connection is a physical connection in a water distribution system between the potable drinking water supply and any non-potable source, which can pose a risk of contamination under certain conditions. On December 19, 2023, the State Water Board adopted the Cross-Connection Control Policy Handbook (CCCPH) which took effect on July 1, 2024, and replaces the crossconnection control regulations found in California Code of Regulations (CCR) Title 17. The primary objective of the CCCPH is the protection of public health through the establishment of standards intended to ensure drinking water supplies are protected from hazards associated with the backflow of unknown substances into the distribution system. Beginning July 1, 2026, all California public water systems are required to comply with the requirements in the CCCPH.

Over time, evolving regulatory requirements and best practices have prompted the development of the attached updated Cross-Connection Control Plan (Plan). The previous Plan is superseded by the new 2025 version which reflects current industry standards and local program needs. The Grover Beach Municipal Code currently does not contain specific provisions addressing crossconnection control or inspection requirements. By adopting the Ordinance with its full regulatory code that implements the requirements from the State Water Board, the City will formalize its authority to administer and enforce the Cross-Connection Control Program, ensuring continued compliance with state and federal regulatory requirements for potable water systems.

The adopted Ordinance and updated Cross-Connection Control Policy will enhance long-term protection of the City’s drinking water supply and safeguard public health within the community.

In addition, it will improve program clarity, operational efficiency, and transparency in the Staff Report: Adoption of the 2025 Cross-Connection Control Plan Page 2 February 10, 2026
Multi-Year Goals
☐ Public Safety and Community Services ☐ Economic Development and Housing ☒ Community Infrastructure ☐ Financial and Organization Sustainability Council Priorities
☒ Water & Wastewater Infrastructure ☐ Community Engagement inspection, testing, and enforcement processes. The second reading and public hearing for this Ordinance will be scheduled for February 23, 2026.

FISCAL IMPACT
All program costs (inspection, permitting, testing and tracking) will continue to be recovered through existing water service fees and backflow prevention program fees. No new expenditures or unfunded mandates are associated with this action.

ALTERNATIVES
The Council has the following alternatives to consider:

1. Introduce and conduct the first reading, by title only, of an Ordinance to Amend Chapter 50 (Water) of Title V (Public Works) of the Grover Beach Municipal Code (GBMC) to add sections 50.030 through 50.039 pertaining to Cross Connection Controls and inspections and schedule the second reading, public hearing and adoption of the Ordinance for the next regularly scheduled meeting; or

2. Do not introduce and conduct the first reading of the Ordinance; or

3. Provide alternate direction to staff.

PUBLIC NOTIFICATION
The agenda was posted in accordance with the Brown Act.

ATTACHMENTS

1. Ordinance No. 26-XX

2. City of Grover Beach 2025 Cross-Connection Control Plan ORDINANCE NO. 26-__

AN ORDINANCE OF THE CITY COUNCIL OF THE CITY OF GROVER BEACH, CALIFORNIA AMENDING CHAPTER 50 (WATER) OF TITLE V (PUBLIC

WORKS) OF THE GROVER BEACH MUNICPAL CODE TO ADD SECTIONS

50.030 THROUGH 50.039 PERTAINING TO CROSS-CONNECTIONS

CONTROL AND INSPECTIONS
WHEREAS, pursuant to Health and Safety Code section 116407, the State Water Resources Control Board (“Board”) developed and adopted the Cross-Connection Control Policy Handbook (“Handbook”) establishing enforceable standards applicable to public water systems; and
WHEREAS, pursuant to Health and Safety Code section 116555.5, a public water system must implement a Cross-Connection Control Program that complies with applicable regulations and standards adopted by the Board pursuant to Health and Safety Code section 116407; and WHEREAS, section 3.1.3, subdivision (a)(1) of the Handbook requires each public water system to have operating rules, ordinances, bylaws, or resolutions to implement the crossconnection program; and WHEREAS, the implementation of a cross-connection control program, in alignment with the Handbook, is essential to the protection of water quality and public health; and WHEREAS, the City of Grover Beach (“City”) hereby desires to adopt an ordinance in compliance with the Handbook to enforce the City’s Cross-Connection Control Plan.

NOW, THEREFORE, BE IT ORDAINED BY THE CITY COUNCIL OF THE CITY OF GROVER BEACH, AS FOLLOWS:

PART 1: Chapter 50 (“Water”) of Title V (“Public Works”) of the Grover Beach Municipal Code is hereby amended to add the following:

CHAPTER 50

CROSS-CONNECTIONS CONTROL AND INSPECTIONS
Section 50.030 - PURPOSE.

Section 50.031 - DEFINITIONS.

Section 50.032 - CONSUMER RESPONSIBILITY.

Section 50.033 - WHERE PROTECTION IS REQUIRED.

Section 50.033.1 - TYPE OF PROTECTION.

Section 50.034 - FREQUENCY OF INSPECTION.

Section 50.035 - INSPECTOR – QUALIFICATION AND CERTIFICATION.

Section 50.036 - BOOSTER PUMP REGULATION.

Section 50.037 - PROTECTION OF WATER SYSTEMS WITHIN PREMISES.

Section 50.038 - WATER SUPERVISOR – REQUIREMENTS.

Section 50.039 - PENALTIES FOR NONCOMPLIANCE.

Attachment 1
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Section 50.030 - Purpose.

The purpose of this subchapter is:

A. To protect the public water supply against actual or potential cross-connections by isolating within the premises contamination or pollution that may occur because of some undiscovered or unauthorized cross-connection on the premises; B. To eliminate existing connections between drinking water systems and other sources of water that are not approved as safe and potable for human consumption; C. To eliminate cross-connections between drinking water systems and other sources of water or process water used for any purpose whatsoever which jeopardizes the safety of the drinking water supply;
D. To prevent the making of cross-connections in the future; E. To encourage the exclusive use of public sources of water supply; and F. To protect the drinking water supply within the premises where plumbing defects or crossconnections may endanger the drinking water supply available on the premises.

It is the intent of this subchapter to recognize that there are varying degrees of hazard and to apply the principle that the degree of protection should be commensurate with the degree of hazard.

Section 50.031 - Definitions.
(A) For the purpose of this subchapter, the following words and phrases are defined, and shall be construed as hereinafter set out, unless it is apparent from the context that they have a different meaning:

AIRGAP SEPARATION. A physical break between a supply pipe and a receiving vessel.

The airgap shall be at least double the diameter of the supply pipe, measured vertically above the top rim of the vessel, in no case less than one inch; APPROVED CHECK VALVE. A check valve meeting the specifications and approval of a recognized, approved testing agency for backflow prevention assemblies; APPROVED DOUBLE CHECK VALVE ASSEMBLY. An assembly of at least two independently acting approved check valves, including tightly closing shut-off valves on each side of the check valve assembly and suitable leak detector drains, plus connections available for testing the water tightness of each valve. The entire assembly shall be made in the factory of the manufacturer and shall meet the specifications and approval of a recognized, approved testing agency for backflow prevention assemblies. To be approved, these assemblies must be readily accessible for maintenance testing;
APPROVED REDUCED PRESSURE PRINCIPLE BACKFLOW PREVENTION DEVICE.

A device approved by a recognized and approved testing agency for backflow prevention assemblies. The entire assembly shall be made in the factory of the manufacturer and shall incorporate two or more check valves and an automatically operating differential relief valve located between the two checks, two shut-off valves, and equipped with necessary appurtenances for testing. The assembly shall operate to maintain the pressure in the zone - 3 -
between the two check valves less than the pressure on the public supply side of the assembly.

At cessation of normal flow, the pressure between check valves shall be less than the supplied pressure. In case of leakage of either check valve, the differential relief valve shall operate to maintain this reduced pressure by discharging to the atmosphere. When the inlet pressure is two pounds per square inch or less, the relief valve shall open to the atmosphere, thereby providing an airgap in the assembly. To be approved, these assemblies must be readily accessible for maintenance and testing and installed in a location where no part of the valve will be submerged;
APPROVED WATER SUPPLY. Any water supply approved by or under the supervision of a public health agency of the State of California, the County of San Luis Obispo, or the City of Grover Beach;
AUXILLIARY WATER SUPPLY. Any water supply on or available to the premises other than the approved public potable water supply. These auxiliary waters may include, but are not limited to, water from another purveyor's public potable water supply or any natural source, such as a well, spring, river, stream, harbor, etc., or “used water” or “industrial fluids”; CONSUMER. The owner of a premises having a service from a potable water system; CONTAMINATION. An impairment of the quality of the water to a degree which creates an actual hazard to public health through poisoning or through the spread of disease; CROSS-CONNECTION or CROSS-CONNECTED. As used in these regulations, means any real or potential connection between any part of a public water system or other water system supplying potable water to members of the public and any auxiliary water supply, or any source or system containing water or any substance that is not or cannot be approved as safe, wholesome, and potable for human consumption;
COUNTY. The Environmental Health Services Division of the Public Health Department of the County of San Luis Obispo;
DEPARTMENT. The Public Works Department of the City of Grover Beach; HEALTH HAZARD. An actual or potential threat of contamination of a physical or toxic nature to the public potable water system to such a degree of intensity that there would be a danger to health;
INDUSTRIAL FLUIDS. Any fluid or solution which may be chemically, biologically, or otherwise contaminated or polluted in a form or concentration, such as would constitute a health, system, pollution, or plumbing hazard if introduced into the water supply. This may include, but is not limited to, polluted or contaminated used waters; all types of processed waters and “used waters” originating from the public potable water system, which may deteriorate in sanitary quality; chemicals in fluid form; acids and alkalis; circulating cooling waters connected to an open cooling tower and/or cooling waters that are chemically or biologically treated or stabilized with toxic substances; contaminated natural waters, such as from wells, springs, streams, rivers, bays, harbors, seas, irrigation canals or systems, etc.; oils; gases; glycerin; paraffines; caustic and acid solutions; and other liquid and gaseous fluids used in industrial or other processes or for fire-fighting purposes;
PLUMBING HAZARD. A plumbing type cross-connection in a consumer’s potable water system that has not been properly protected by a vacuum breaker, airgap separation, or other assembly or device. The term “plumbing hazard” includes, but is not limited to, crossconnections to toilets, sinks, lavatories, wash trays, domestic washing machines, and lawn sprinkling systems;
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POLLUTION. An impairment of the quality of the water to a degree which does not create an actual hazard to the public health, but which does adversely affect such waters for domestic use;
POLLUTION HAZARD. An actual or potential threat to the physical properties of the public water system or the potability of the public water supply, but which would not constitute a health or system hazard, as defined;
PURVEYOR. Any person, corporation, public utility, municipality, district, or other agency or institution furnishing or supplying water for domestic purposes; SERVICE CONNECTION. The terminal end of a service connection from the public potable water system, i.e., where the water purveyor loses jurisdiction and sanitary control over the water at its point of delivery to the consumer’s water system. If a meter is installed, then the service connection shall mean the downstream end of the meter. There should be no unprotected take-offs from the service line ahead of any meter or backflow prevention device located at the point of delivery to the consumer’s water system; SYSTEM HAZARD. An actual or potential threat of severe damage to the physical properties of the public potable water system; and
WATER SUPERVISOR. The consumer, or a person on the premises appointed by the consumer who is charged by the consumer with the responsibility to the consumer of maintaining the consumer’s water system free from cross-connections and other sanitary defects, as required by regulations and laws. A certified backflow prevention assembly tester may not act as a water supervisor unless he is a full-time employee of the consumer and has the day-to-day responsibility for the installation and use of pipelines and equipment on the premises and for the avoidance of cross-connections.
(B) Words and phrases not defined in this code are construed according to the approved usage of the language, or, when appropriate, by reference to definitions contained in state or federal law.

Section 50.032 - Consumer Responsibility.

Consumers shall be responsible for the installation and use of pipelines and equipment for the avoidance of cross-connections, compliance with the provisions of this chapter, and for reporting to the Department any changes in water usage. In the event of any cross-connection existing or occurring on or within the premises, the Department shall be immediately notified by the consumer so that appropriate corrective measures may be taken.

Section 50.033 - Where Protection is Required.

A. The Department will conduct an initial hazard assessment of the user premises within its service area to identify actual or potential cross-connection hazards, degree of hazard, and any backflow protection needed.

B. The County will determine the necessity of backflow prevention devices at each service connection from the public water system for supplying water to premises having an auxiliary water supply for protection against backflow of water from the premises into the public water system.

C. Each service connection from the public water system for supplying water to premises on which any substance is or may be handled in such a fashion as to permit entry into the - 5 -
water system shall be evaluated to protect against backflow of the substance from the premises into the public system. This shall include the handling of processed waters and waters originating from the public water supply system which have been subject to deterioration in sanitary quality.

D. Backflow prevention assemblies shall be installed on the service connection to any premises that have cross-connections and the County determines necessary. After the County’s initial testing, it shall be the responsibility of the consumer to provide, test, and maintain protective assemblies as required.

Section 50.033.1 - Type of Protection.

The protective assembly required shall depend on the degree of hazard. In determining the degree of hazard and the type of backflow prevention to be required, the following criteria shall be used:

A. An airgap separation shall be used where there is a health hazard. The airgap shall be located as close as practicable to the meter and all piping between the meter and the receiving tank shall be entirely visible. If these conditions cannot reasonably be met, the public water supply shall be protected with an approved reduced pressure principle backflow prevention assembly, providing the alternative is acceptable to the Department; B. An airgap separation or a reduced pressure principle backflow prevention assembly shall be used where there is a system hazard or a plumbing hazard or any combination of the above. If an airgap separation is used, the airgap shall be located as close as practicable to the meter and all piping between the meter and receiving tank shall be entirely visible.

Where there is no meter, the protective assembly shall be located on the service connection pipeline at a point on the consumer’s property nearest the public water supply pipeline;
C. In all other cases of cross-connection, there shall be required a double-check valve assembly;
D. Notwithstanding any other provisions of this section, at the service connection to any sewage treatment plant, sewage pumping station, or storm water pumping station, the public water supply shall be protected by an airgap separation. The airgap shall be located as close as practicable to the meter and all piping between the meter and receiving tank shall be entirely visible. If these conditions cannot be reasonably met, the public water supply shall be protected with an approved reduced pressure principle backflow prevention assembly, providing this alternative is acceptable to the Department.

Final decision in this matter shall rest with the State Department of Public Health; and E. Notwithstanding any other provisions of this section, on any premises where the Environmental Health Services Division determines that a special hazard exists, the public water supply shall be protected by such approved backflow prevention assembly as designated by the Environmental Health Services Division. - 6 -
Section 50.034 - Frequency of Inspection.

It shall be the duty of the consumer on any premises on which backflow protective assemblies are installed to have competent inspections made upon installation, and at least once a year thereafter, or more often in those instances where successive inspections indicate defective operation. These assemblies shall be repaired, overhauled, or replaced at the expense of the water user whenever they are found to be defective. Records of such tests, repairs, and overhaul shall be kept and submitted to the Department.

Section 50.035 - Inspector – Qualification and Certification.

A. No person shall be qualified to inspect and maintain backflow prevention assemblies unless his/her qualifications have been established to the satisfaction of the County of San Luis Obispo Environmental Health Services Division, as set forth in this section. To determine the qualifications of any person to inspect and maintain backflow prevention assemblies, the Department shall require documentation of a current American Water Works or American Backflow Prevention Association certificate or other approved certifying agency certificate be submitted. Such certification shall be submitted to the Department along with a current report of calibration of their test gauge equipment. The Department shall make available to consumers, a list of persons qualified to inspect and maintain backflow prevention assemblies. Qualified testers shall be issued a County of San Luis Obispo tester identification (I.D.) card, and such identification shall be kept in the immediate possession of every qualified tester while said qualified tester is inspecting or maintaining any backflow prevention assembly in the County of San Luis Obispo.

B. Every person desiring to qualify to inspect or maintain backflow prevention assemblies shall make application to the County.

C. Every person holding a County of San Luis Obispo tester I.D. card issued by the County pursuant to the provisions of this subchapter shall be required to renew their I.D. card every three years. The requirements for reexamination may be waived at the discretion of the County.

D. Every person receiving a County of San Luis Obispo tester I.D. card pursuant to the provisions of this subchapter shall be responsible for the competency and accuracy of all inspections and maintenance performed by him or her on any backflow prevention assembly.

E. Any person issued a County of San Luis Obispo tester I.D. card who violates or fails to comply with any of the provisions of this subchapter or willingly falsifies inspection or maintenance reports submitted to the Department shall, in addition to the penalties prescribed in Chapter 37 of the Grover Beach Municipal Code, have the tester I.D. card immediately revoked, and shall not be considered for recertification for a period of two years.

Section 50.036 - Booster Pump Regulation.

When it becomes necessary, because of low pressure or special operating conditions, to install a booster pump on the service of any premises, such pump shall be equipped with a low- - 7 -
pressure cutoff switch designed to shut off the pump when the pressure on the inlet side is twenty-five pounds per square inch gauge or lower. It shall be the duty of the consumer to maintain the cut-off assembly in proper working order, and to certify to the Department at least once a year that the assembly is operable.

Section 50.037 - Protection of Water Systems Within Premises.

A. Whenever the Department determines that drinking water systems on a premises cannot be protected against entry of water from any piping system, equipment or other source not safe or potable for human use, an entirely separate drinking water system shall be installed to supply water at convenient points.

B. Water systems for fighting fire, derived from a supply that cannot be approved as safe or potable for human use shall, wherever practicable, be kept wholly separate from drinking water pipelines and equipment. In cases where the domestic water system is used for both drinking and firefighting purposes, approved backflow prevention assemblies shall be installed to protect such individual drinking water lines as are not used for firefighting purposes. The users of such drinking water systems shall be further protected as prescribed by the State and County Health Departments.

C. Potable water pipelines connected to equipment for industrial processes or operations shall be disconnected therefrom if practicable. Where disconnection is not practicable, an approved backflow prevention assembly, the type or kind depending on the degree of hazard, shall be located in the feedline to the process piping or equipment, beyond the last point from which drinking water may be taken. In the event the particular processed liquid is especially corrosive or apt to prevent reliable action of the backflow prevention assembly, an airgap separation shall be provided. These assemblies shall be repaired, overhauled, or replaced whenever they are found to be defective. Records of tests, repairs, and replacement shall be kept and submitted to the Department.

D. Sewage pumps and storm water pumps shall not have priming connections directly off any drinking water systems, unless the drinking water system is protected by an airgap and no connection shall exist between the drinking water system and any other piping, equipment, or tank in any sewage treatment plant, sewage pumping station, or storm water pumping station.

E. Backflow protection by an approved backflow protection device operating under the reduced pressure principle shall be provided on each drinking water outlet used for supplying ships or other vessels at piers or waterfronts. These devices must be located where they will prevent the return of water from any ship or vessel into another adjacent ship or vessel or into the public water system.

F. Where the premises contain dual or multiple water systems and piping, the exposed portions of pipelines shall be painted, banded, or marked at sufficient intervals to distinguish clearly which water is safe for drinking purposes and which is not safe. All outlets from other than approved water supply systems shall be posted as being unsafe - 8 -
for drinking purposes. All outlets intended for drinking purposes shall be plainly marked to indicate that fact.

Section 50.038 - Water Supervisor – Requirements.

At each premises where it is necessary, in the opinion of the Department, a water supervisor shall be designated.

Section 50.039 - Penalties for Noncompliance.

The water purveyor shall have the authority to immediately discontinue service to any premises where cross-connection or other hazards to the water system are found to exist and shall not again render service to said premises until such conditions are eliminated in accordance with this chapter. Any consumer who willfully violates any of the provisions of this chapter or alters, bypasses, or renders inoperative any backflow prevention assembly installed under the provisions of this chapter shall, in addition to immediate discontinuance of water service, be subject to penalties prescribed in Chapter 37 of the Municipal Code. Service shall not again be rendered until such violation or noncompliance has been corrected.

Part 2: Severability. If any part of this ordinance is held invalid for any reason by a court of competent jurisdiction, such decision shall not affect the validity of the remaining portion of this ordinance, and the City Council hereby declares that it would have passed the remainder of the ordinance if such invalid portion thereof had been deleted.

Part 3: Effective Date. This ordinance shall take effect and be in force thirty (30) days from and after its final passage.

Part 4: Publication. Within fifteen (15) days after passage, the City Clerk shall cause this ordinance to be published in a newspaper of general circulation. If a summary of the ordinance is published, the City Clerk shall cause a certified copy of the full text of the proposed ordinance to be posted at City Hall at least five (5) days prior to the meeting at which the ordinance is adopted and again after the meeting at which it is adopted. [SIGNATURES ON FOLLOWING PAGE]
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INTRODUCED at a regular meeting of the City Council held on ___________________ ___, 2026, and PASSED, APPROVED, and ADOPTED by the City Council at a regular meeting on ______________ ___, 2026, on the following roll call vote, to wit:

AYES: Council Members -
NOES: Council Members -
ABSENT: Council Members -
ABSTAIN: Council Members -
RECUSED: Council Members -
APPROVED:
__________________________
Kassi Dee, Mayor
ATTEST:
____________________________________
Wendi Sims, City Clerk
APPROVED AS TO FORM:
_____________________________________
Jennifer Thompson, City Attorney
{4918-5764-4165, v.2}

CITY OF GROVER BEACH

PUBLIC WORKS DEPARTMENT

CROSS-CONNECTION CONTROL PLAN
PWS CA 4010004—Permit Number 04-06-23P-014
June 2025
Attachment 2

CITY OF GROVER BEACH
Cross-Connection Control Plan 2 June 2025
Acronyms and Abbreviations
The following are acronyms, abbreviations, and definitions used in this plan:

AG Air Gap Separation
CGBPWD City of Grover Beach Public Works Department
BAT Best Available Technology
BPA Backflow Prevention Assembly
CCC Cross-Connection Control
CCR California Code of Regulations
COUNTY County of San Luis Obispo, Department of Public Health, Environmental Health Division DCV Double Check Valve assembly
DDCV Double Detector Check Valve assembly
EPA Environmental Protection Agency
PVB Pressure Vacuum Breaker assembly
PWS Public Water System
RP Reduced Pressure principal backflow assembly
RW Recycled Water
SDWA Safe Drinking Water Act
STATE State Water Resources Control Board, Drinking Water Division USPS United States Postal Service

CITY OF GROVER BEACH
Cross-Connection Control Plan 3 June 2025
Plan Certification
I certify that the information submitted in this cross-connection control plan is based on the best available information and the plan is in substantial conformance with the requirements contained in the Cross-Connection Control Policy Handbook, which were incorporated into the STATE Drinking Water Regulations that became effective July 1, 2024.

City of Grover Beach Public Works Department
Name: Billy Haas
City of Grover Beach
Public Works Department
Title: Superintendent
Signature: Date:

Designated Certified Cross-Connection Specialist
Name: Matthew Giuffrida
County of San Luis Obispo
Department of Public Health
Environmental Health Division
Title: CCC Specialist AWWA #03152
Signature: Date: 6/27/2025
6/27/2025

CITY OF GROVER BEACH
Cross-Connection Control Plan 4 June 2025
System Information
Water System Name City of Grover Beach
Water System Type Privately-owned mutual water company
Water System Number CA 4010004
Number of Single-Family Residential Service
Connections
4203
Number of Multifamily Residential Service
Connections
352
Number of Commercial Connections 239
Number of Industrial Service Connections 31
Number of Agricultural Service Connections 0
Number of Landscape Irrigation Connections 73
Total Number of Service Connections 5013
Existing Cross-Connection Control Information
Number of Fire Protection System Service Connections 32 Verify if fire protection system alternative is needed
Number of Air Gaps used for backflow protection at the
service connection
0 Attach list of air gaps and
procedures to Plan
Number of Service Connections where internal protection is used in lieu of premises containment
0 Number of Recycled Water (RW) use sites 0 Verify if any RW use sites use swivel-els or air gaps
Number of Swivel-ells used for backflow protection at the service connection (applies to Recycled Water use sites) 0 Attach Swivel-el list and
procedures to Plan
Number of Sites requiring a water user supervisor (Crossconnection Control Handbook Section 3.2.2(f)) – applies to any sites using recycled water, complex piping systems, or a user supervisor deemed necessary by Anytown Mutual Water Company.
0 Attach list of user supervisors
and associated sites to Plan
Attachments to this Plan:

A. Board Policy 1.2.22, Cross-Connection Control

CITY OF GROVER BEACH
Cross-Connection Control Plan 5 June 2025
Requirement for Program
City of Grover Beach Public Works Department (CGBPWD) hasthe responsibility to protect the public watersupply through implementation and enforcement of a Cross-Connection Control (CCC) Plan.

CCC Plan requirements are contained in the CCC Policy Handbook, which was incorporated into the STATE’s Drinking Water Regulations and became effective July 1, 2024.

A. Program Objectives
The objective of the CCC Plan isto prevent the occurrence of backflow into CGBPWD’s water distribution system to protect customers from contamination or pollution from any water user’s onsite hazards.

B. Required Elements of Program
The CCC Policy Handbook requiresthe CCC Plan for CGBPWD to include certain minimum elements. Per the CCC Policy Handbook, the minimum required elements of a CCC Plan are:

1. Operating rules or ordinances

2. Cross-connection control program coordinator

3. Hazard assessments

4. Backflow prevention

5. Certified backflow prevention assembly testers and certified cross-connection control specialists

6. Backflow prevention assembly testing

7. Recordkeeping

8. Backflow incident response, reporting and notification

9. Public outreach and education

10. Local entity coordination.

CITY OF GROVER BEACH
Cross-Connection Control Plan 6 June 2025
Element 1: Operating Rules or Ordinances (Legal Authority).

Per the CCC Policy Handbook, CGBPWD must have operating rules, ordinances, by-laws, resolution, or service contract or agreement to implement a CCC Plan.

Grover Beach contracts with the County of San Luis Obispo to administer the CrossConnection Control Program under authority of County Code chapter 8.030.

CGBPWD’s adopted policy also authorizes CGBPWD to deny or discontinue water service to a property in the event a water user fails to comply with CCC Plan requirements in a timely manner.

Element 2: Cross-Connection Control Plan Coordinator.

A CCC specialist must be a permanent or contracted employee of CGBPWD. The CCC specialist, or the CCC specialist designee, must be able to be contacted within one hour.

To meet the certified CCC specialist requirement, CGBPWD has contracted with the COUNTY of San Luis Obispo Public Health Department, Environment Health Division (COUNTY) to provide the necessary CCC expertise and services.

1. COUNTY will conduct a survey by performing a thorough inspection of all water uses for cross-connections. COUNTY will prioritize surveys of special hazard facilities. If corrections are necessary or if other need arises, COUNTY will conduct additional surveys as needed to confirm compliance, follow-up on corrections or identify newly created cross-connections.

2. COUNTY will prepare and maintain written survey reports, water user notices, correction notices, and follow-up reports.
a. Water User Notices
i. COUNTY will provide a written survey report to a water user listing cross connections found on the user's premises. COUNTY will notify the water user of the corrective action required, if any, and the required compliance date. ii. COUNTY will follow up with the water user to confirm that corrective action was performed in a timely manner and compliance has been achieved or if non-compliance continues. COUNTY will inform the water user of further corrective action and required compliance dates as needed. COUNTY will reinspect as needed until compliance is accomplished.

CITY OF GROVER BEACH
Cross-Connection Control Plan 7 June 2025
b. Notices to CGBPWD. COUNTY will provide a copy of the survey report and letter to the water user to AWMC. COUNTY will provide a copy of the follow-up letters(s) to the user confirming compliance or notifying the water user of further corrective action and compliance dates.

3. COUNTY will perform the following enforcement measures. a. To the extent the COUNTY would normally prosecute San Luis Obispo COUNTY Code violations, COUNTY may prosecute violations of any COUNTY ordinances related to cross-connections.
b. COUNTY will also cite any State laws, non-County ordinances, CGBPWD resolutions or policies in a correction letter to a water user. c. CGBPWD may pursue enforcement as appropriate.
d. COUNTY will conduct or assist CGBPWD staff in the investigation of backflow incidents and other water quality problems.

4. Backflow Prevention Devices.
a. COUNTY will determine the necessity of backflow prevention devices at the water service connection for the protection of the water main where internal protection does not solve the total cross-connection problem.
b. COUNTY will maintain a list of known backflow devices and the known location of the devices in service in CGBPWD 's service area.
c. COUNTY will provide a diagram for the proper installation of approved backflow prevention devices. If a manufacturer's installation instructions, diagrams or both are available, providing the manufacturer's material shall satisfy this obligation.

5. COUNTY will perform plan checks of water usage when requested by CGBPWD when necessary to supplement Building Department plan reviews.

6. Testing. The CCC Policy Handbook requires the testing of BPAs upon installation and at least annually thereafter.
a. COUNTY will perform the initial testing of BPAs upon installation. b. COUNTY will notify the water user when testing is due.

CITY OF GROVER BEACH
Cross-Connection Control Plan 8 June 2025
c. COUNTY will supply a list of qualified backflow prevention device testers. d. COUNTY will follow up on delinquent reporting of test results. e. COUNTY will update records when testing reports are received. f. COUNTY will evaluate testing results for inadequacies.

7. CGBPWD will distribute public education and outreach material and assist with coordination with local entities.

The table below identifies the current certified specialist retained on contract by CGBPWD to manage CGBPWD’s CCC program and/or act as the CCC technical resource for CGBPWD:

Name of ContractedCertified CCC Specialist
(Primary)
Matthew Giuffrida
Address County of San Luis Obispo
Public Health Department
Environmental Health Division
2156 Sierra Way
San Luis Obispo, CA 93406
Email [email protected]
Phone Number 805.781.5567
Specialist Certification Number and
Certifying Organization
AWWA CCC Specialist Cert #03152
AWWA BPAT Cert #17341
Name of CCC Coordinator Billy Haas
Address 154 S. 8th St.

Grover Beach, Ca. 93433
Email [email protected]
Phone Number 805.473.4530
Name of 24-hour CCC Contact Billy Haas
Title Superintendent
Email [email protected]
24-hour Phone Number 805.801.0875

CITY OF GROVER BEACH
Cross-Connection Control Plan 9 June 2025
Element 3: Hazard Assessments.

CGBPWD must survey its service area and conduct hazard assessments per CCC Policy Handbook, Chapter 3, Article 2 that identifies actual or potential cross-connection hazards, degree of hazard, and any backflow protection needed.

Initial Cross-Connection Hazard Assessments
In accordance with the CCC Policy Handbook, Section 3.2.1, CGBPWD must conduct an initial hazard assessment of the user premises within its service area. The hazard assessment must consider the following criteria:
a. The existence of cross-connections
b. The type and use of materials handled and present, or likely to be, on the user’s premises c. The degree of piping system complexity and accessibility d. Access to auxiliary water supplies, pumping systems, or pressure systems e. Distribution system conditions that increase the likelihood of backflow f. User premises accessibility
g. Any previous backflow incidents on the user premises h. The requirements and information provided in the CCC Policy Handbook.

The procedures for conducting the hazard assessments are as follows:

1. For industrial service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

2. For commercial service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

CITY OF GROVER BEACH
Cross-Connection Control Plan 10 June 2025

3. For agricultural service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises. • Monitor requests for any new agricultural service connections and may utilize the hazard assessment procedures noted above. No agricultural service connections currently exist within CGBPWD’s service area.

4. For landscape irrigation service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

5. For single-family residential service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Provide the resident a cross connection self-assessment survey form for review. • Review new water service applications for hazard identification with the presumption of low hazard.
• Review hazard assessments previously conducted at the user premises.

6. For multi-family residential service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

7. For temporary service connections (i.e., fire hydrant connections used for construction projects, emergency services connections), CGBPWD will:
• Review temporary connection applications for hazard identification • Conduct onsite assessments or site surveys for hazard identification Cross-Connection Hazard Survey Schedule for Initial Hazard Assessments The schedule for initial hazard assessment is outlined in the following table. The schedule starts from the date the CCC Plan is established (no later than July 1, 2025).

CITY OF GROVER BEACH
Cross-Connection Control Plan 11 June 2025
Initial Assessment Task Estimated number to
be completed per
year
Estimated
Completion Date
Hazard assessment of new connections will occur prior to initiating water service. All new water
service connections Ongoing
Hazard assessment of high-hazard, non-residential service connections which are listed on Appendix D of the CCC
Policy Handbook
6 July 1, 2030
Hazard assessment of non-high hazard non-residential service connections 23 July 1, 2035
Hazard assessment of residential service connections
with special plumbing facilities or auxiliary water use As identified July 1, 2035 Hazard assessment of all other residential service
connections
Performed via
survey; est. 425/yr July 1, 2035
Fire Protection (Sprinkler) Connections BPA
assessment and installation 5 July 1, 2035
Cross-Connection Hazard Survey Schedule for Subsequent Hazard Re-Assessments In accordance with CCC Policy Handbook, Section 3.2.1(e), CGBPWD will perform a hazard reassessment if one of the following criteria applies:
a. If a user premises changes account holder (excluding single family residences). b. If a user premises is newly connected or re-connected to CGBPWD water distribution system.
c. If evidence exists of changes in the activities or materials on a user’s premises. d. If a backflow occurs from a user’s premises.
e. Periodically, as identified in this Plan.
f. If the STATE requests a hazard assessment of a user’s premises. g. If CGBPWD concludes an existing hazard assessment may no longer accurately represent the degree of hazard.

For subsequent cross-connection hazard re-assessments, procedures for evaluating the backflow protection requirements are:

1. For hazard reassessment of industrial service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

CITY OF GROVER BEACH
Cross-Connection Control Plan 12 June 2025

2. For hazard reassessment of commercial service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

3. For hazard reassessment of agricultural service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises. • Monitor requests for any new agricultural service connections and may utilize the hazard assessment procedures noted above. No agricultural service connections currently exist within ATMWC’s service area.

4. For hazard reassessment of landscape irrigation service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

5. For hazard reassessment of single-family residential service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Provide the resident a cross connection self-assessment survey form for review. • Review new water service applications for hazard identification with the presumption of low hazard.
• Review hazard assessments previously conducted at the user premises.

6. For hazard re-assessment of multi-family residential service connections, CGBPWD will:
• Review available records on file and/or water service applications for hazard assessment.
• Conduct onsite assessments or site surveys for hazard identification. • Review new water service applications for hazard identification. • Review hazard assessments previously conducted at the user premises.

CITY OF GROVER BEACH
Cross-Connection Control Plan 13 June 2025
Element 4: Backflow Prevention.

CGBPWD will ensure that actual and potential cross-connections are eliminated when possible or controlled by the installation of approved BPAs or air gaps consistent with the requirements of the CCC Policy Handbook Article 3.

Backflow Preventer Requirements
CGBPWD will require that water service to water users with identified hazards be protected at the service connection in a manner acceptable to CGBPWD. All service connections identified as high hazard shall be isolated with an RP or air gap as appropriate.

CGBPWD will require temporary meters (i.e., meters used for temporary service connections at fire hydrants for construction projects) to be equipped with an RP. CGBPWD will inspect temporary meter connections within five (5) working days of initiating service to ensure that adequate backflow protection provided is appropriate with onsite hazards.

Approved BPAs and Installation
CGBPWD will ensure that BPAs are approved and installed in accordance with standards noted in CCC Policy Handbook Section 3.3.1 and 3.3.2.

All BPAs must be installed:
a. In the orientation for which they are designed; and
b. In a manner and location that facilitates their proper operation, maintenance, and testing or inspection; and
c. In a manner that will protect them from weather-related conditions such as flooding and freezing; and
d. At locations that are readily accessible; and
e. In compliance with applicable safety regulations.

CGBPWD has adopted standards for the construction and installation of BPAs. CGBPWD’s Superintendent is responsible for overseeing construction of new installations. CGBPWD’s Chief Operator is responsible for ensuring the water service for a new installation is not initiated until the BPA passes its initial test.

Schedule for Installation of BPAs
The following table shows the schedule that CGBPWD will follow for installation of BPAs when required (based on the hazard assessment).

Type of Service Schedule
New connections with identified hazards Before water service isinitiated Existing connections with known high hazards Within 60days after water user notification

CITY OF GROVER BEACH
Cross-Connection Control Plan 14 June 2025
Type of Service Schedule
Existing fire protection systems using chemicals or supplied by an unapproved auxiliary water source (e.g., well)
Within 60 days after water user
notification
Existing fire protection systemsthat do not use chemicals and are supplied by CGBPWD
Within 60 days after water user
notification
Air Gaps
Air gaps are subject to the following:
a. The receiving water container must be located on the water user’s premises at the service connection unless an alternate location has been approved by CGBPWD. b. All piping between the water user’s service connection and the discharge location of the receiving water container must above finished grade and be accessible for visual inspection unless an alternative piping configuration is approved by CGBPWD. c. CGBPWD will ensure that the air gap meets requirements listed in CCC Policy Handbook Appendix B.
d. New air gap installations at water users’ service connections must be reviewed and approved by the STATE prior to installation.

Enforcement
When the water user fails to install the required backflow protection within 60 days of Element 5: Certified BPA Testers and Certified CCC Specialists.

CGBPWD will ensure all BPA testers and CCC specialists used are certified in accordance with CCC Policy Handbook Article 4.

ATMWC will use a current list of pre-approved BPA testers and/or CCC Specialists maintained by the COUNTY as sufficient evidence of qualification.
• COUNTY Contact: Matt Giuffrida
• Phone Number: 805.781.5567
• Email: [email protected]
CGBPWD will ensure that each BPA is field tested by a person with a valid certification prior to forwarding document submissions to the COUNTY CCC Specialist.

CITY OF GROVER BEACH
Cross-Connection Control Plan 15 June 2025
COUNTY utilizes an online portal that requires testers to submit proof of certification and test kit calibration during the registration process. The portal does not allow testers to submit test results if their certification and/or calibration are not current. Document submissions will be reviewed by the CCC Specialist prior to approval.

Quality Assurance
• CGBPWD’s Chief Operator will review BPA inspection/test report forms submitted by the certified BPA testers within 30 days of receipt.
• COUNTY CCC Specialist will provide final review and approval. • CGBPWD Chief Operator and COUNTY CCC Specialist will provide follow-up test reports that are deficient in any way.
• COUNTY CCC Specialist will report incidences of fraud or gross incompetence on the part of any certified tester to the certifying organization.

Element 6: BPA Testing.

CGBPWD will develop and implement a procedure for ensuring all BPAs are field tested, inspected, and maintained and air gaps are inspected and maintained in accordance with CCC Policy Handbook Section 3.3.3.

1. Inspection and Testing of BPAs
All BPAs used for CGBPWD’s CCC Program will be subject to inspection and, if applicable, testing by CGBPWD. This includes BPAs installed for internal protection within a user’s premises in lieu of premises containment. CGBPWD must have access to the user premises and must ensure that the on-site protection meets the requirements of the CCC Policy Handbook for installation, field testing, and inspections.

Inspection and testing of BPAs will be as follows:
• CGBPWD’s certified CCC specialist will inspect BPAs for proper application (i.e., to ensure that the BPA installed is commensurate with the degree of hazard). • Either a certified CCC specialist or certified BPA tester will perform inspections of BPAs for correct installation.
• A certified BPA tester will test assemblies.

CITY OF GROVER BEACH
Cross-Connection Control Plan 16 June 2025

2. Frequency of Inspection and Testing
Inspection and testing of BPAs will be conducted:
• At the time of installation
• Annually (approximately every 12 months) or more frequently after installation • After a backflow incident
• After BPA repair, reinstallation, relocation, or re-plumbing CGBPWD, STATE, or COUNTY may require a BPA to be inspected and/or tested more frequently than once a year.

3. Responsibility for Inspection and Testing
To ensure that all BPAs are inspected and tested, CGBPWD will: require the customer to be responsible for inspection, maintenance, and testing of BPAs that are owned by the customer.

4. Approved Test Procedures
CGBPWD will require that all assemblies relied upon to protect the public water system be tested in accordance with the test procedures described in the University Southern California Manual of Cross-Connection Control, 10
th Edition.

5. Notification of Routine (i.e. Annual) BPA Testing
COUNTY will notify customers by mail who own BPAs used for public water system protection to have their BPA(s) inspected and/or tested each year. Notices will be sent out not less than 30 days before the due date of the inspection and/or test. The notice will also specify the date (up to 30 days after the due date of the inspection and/or test date) by which the test report must be received by CGBPWD.

6. Notification of Non-Routine BPA Testing
In situations when non-routine BPA inspection and/or testing is needed, CGBPWD will notify customers by mail to have their BPA(s) inspected and/or tested. The notice will also specify the date (up to 30 days after the due date of the inspection and/or test date) by which the test report must be received by CGBPWD.

CITY OF GROVER BEACH
Cross-Connection Control Plan 17 June 2025

7. Notification of Inspection of Internal Protection at CGBPWD -Owned Water Supply Treatment/Storage Facilities
Facilities that produce, treat, store or distribute drinking water must have proper internal protection from internal cross-connections to ensure that the drinking water supplies are protected from cross-connections.

CGBPWD will routinely inspect any non-testable devices to verify the device is in operating condition.

CGBPWD will conduct a cross-connection survey of the facilities every year to ensure internal protection is adequate

8. Enforcement
CGBPWD may terminate water service to the property or arrange for testing of the device by a certified CCC tester and bill the customer if CGBPWD has not received a test report within 30 days after the due date specified in the notice to test the BPA.

Element 7: Recordkeeping.

CGBPWD will develop and implement a recordkeeping system in accordance with the CCC Policy Handbook Section 3.5.1.

1. Types of Records and Data to be Maintained
CGBPWD will maintain the following records, which must be made available to the STATE upon request:
• Two most recent hazard assessments for each customer’s premises. • Information on each BPA used for public water supply protection, including the associated hazard or application, location, owner, type, manufacturer and model, size, installation date (if known), and serial number.
• Information on air gaps used for public water supply protection, including installation, associated hazard or application, location, owner, and as-built plans of the air gap. • Results of all BPA field testing, air gap inspections, swivel-ell inspections, and field tests for the previous three calendar years, including the BPA tester name and certification number, BPA test date, BPA repair date.
• Information on repairs made to, or replacement or relocation of, BPAs for the previous three calendar years.
• Information on the most current cross-connection tests performed.

CITY OF GROVER BEACH
Cross-Connection Control Plan 18 June 2025
• Information on user supervisors if required for customers’ premises, including current contact information, any applicable training and qualifications. • Descriptions and follow-up actions related to all backflow incidents. • Information on any contractors used to carry out any tasks involved with the CCC program, including contact information, service contract, etc. • Public outreach or education materials for the previous three calendar years.

2. Methods of how data is maintained and/or stored
CGBPWD will maintain records using the following methods:

Item Method
Hazard Assessments Digital
BPA Information Digital
Air Gap, Swivel-El Information Digital
BPA field test reports Digital
BPA Installation, Repair, Replacement Digital
Certification information of BPA testers and CCC Specialists Digital Backflow Incident Documentation Digital
Public Outreach, Education Materials Digital
CCC Program Contractor information (if a contractor is used) Digital Element 8: Backflow Incident Response, Reporting, and Notification.

CGBPWD will develop and implement procedures for investigating and responding to suspected or actual backflow incidents in accordance with CCC Policy Handbook Section 3.5.

CGBPWD will describe its procedures for investigating and responding to suspected backflow incidents, including but not limited to the following:
a. Consideration of complaints or reports of changes in water quality as possible incidents of backflow
b. Water quality sampling and pressure recording; and
c. Documentation of the investigation and any response and follow-up activities

CITY OF GROVER BEACH
Cross-Connection Control Plan 19 June 2025

1. Backflow Incident Response Plan
CGBPWD’s CCC Specialist and Chief Operator will participate in developing a backflow incident response plan. The incident response plan will include, but will not be limited to:
• Notification of affected service area population.
• Notification and coordination with other agencies, such as the STATE, and the local health jurisdiction.
• Identification of the source of backflow substance.
• Isolation of the source of backflow substance and the affected area(s). • Mitigation measures to correct the problem.
• Application of corrective actions to prevent future backflow occurrences. • Documentation of the backflow incident investigation, response, and follow-up actions.

2. Backflow Incident Notification
CGBPWD will notify the STATE and local health agencies of any known or suspected incident of backflow within 24 hours of the determination.

State Water Board – Division of Drinking Water
Contact Information:

District 06 – Santa Barbara
Office Phone: 805.566.1326
Emergency Phone: 805.440.9627
If required by the STATE, CGBPWD must issue a Tier 1 Public Notification. The STATE may also require CGBPWD to submit a written incident report describing the details and affected areas of the backflow incident, CGBPWD actions in response to the backflow incident, and follow up actions to prevent future backflow incidents.

The General Manager will issue notifications if required by the STATE.

CITY OF GROVER BEACH
Cross-Connection Control Plan 20 June 2025
Element 9: Public Outreach and Education.

CGBPWD must implement a CCC public outreach and education program element that includes educating CGBPWD staff, customers, and the community about backflow protection and CCC. CGBPWD may implement this requirement through a variety of methods which may include providing information on CCC and backflow protection.

CGBPWD will distribute CCC education materials using the following methods: (choose all that apply)
• New Customer Documentation
• Periodic Water Bill Inserts
• Pamphlet Distribution
• Customer Emails
• CGBPWD Website: www.grover.org
• COUNTY Informational Website:
https://www.slocounty.ca.gov/departments/health-agency/publichealth/environmental-health-services For residential customers, it is recommended that educational materials describe the cross-connection hazards in homes and the recommended assemblies or devices that should be installed by the homeowner to reduce the hazard to the public water system.

The education program should emphasize the responsibility of the customer in preventing the contamination of the public water supply. Other education information distributed by CGBPWD can include, but not be limited to, the following:
• Cross-connection hazards in general.
• Irrigation system hazards and corrective actions.
• Fire sprinkler cross-connection hazards.
• Point-of-use treatment (i.e. household softeners, reverse osmosis units) crossconnection hazards. • Auxiliary water supply (i.e. privately-owned wells, graywater or other non-potable water use) cross-connection hazards.
• Importance of annual inspection and/or testing of backflow preventers. • Thermal expansion in hot water systems when backflow preventers are installed for premises isolation.

CITY OF GROVER BEACH
Cross-Connection Control Plan 21 June 2025
Element 10: Local Entity Coordination
Per the CCC Policy Handbook, CGBPWD must coordinate with applicable local entities that are involved in either CCC or public health protection to ensure hazard assessments can be performed, appropriate backflow protection is provided and provide assistance in the investigation of backflow incidents. Local entities may include but are not limited to plumbing, permitting, or health officials, law enforcement, fire departments, maintenance, and public and private entities.

Local Entity Contact Name Contact Info (Phone, email)
County of San Luis Obispo
Environmental Health
Matthew Giuffrida 805.781.5567
City of Grover Beach
Public Works
Billy Haas 805.801.0875
Five Cities Fire Authority
Fire Department
Varies 805.473.5490

CITY OF GROVER BEACH
154 S EIGHTH ST
GROVER BEACH CA 93433
2024 Annual Report generated 06/27/2025
Assembly Stats
A Active assemblies as of the date of this report
B Assemblies with no test in 2024
C New assemblies Added in 2024
D Assemblies removed/inactivated
Test Stats
E Passed tests in 2024
F Failed tests in 2024
G Tests after repair in 2024
H Late tests in 2024
Contact Id Name Site Id Address A B C D E F G H
408753 200 S. FOURTH STREET FA0013224 200 S FOURTH 3 0 0 0 3 0 0 0 408034 248 N. 14TH STREET TOWNHOMES
HOA
FA0010807 248 14TH ST 3 0 0 0 3 0 0 0
409589 675 W. GRAND FA0012249 675 W GRAND AVE 2 1 0 0 1 1 0 0 417087 Albertsons FA0017150 1758 W Grand Ave 9 1 0 0 8 0 0 0 411993 Anthony Toste FA0017171 941 Griffin St 1 0 0 0 1 0 0 0 408980 ARROYO HERITAGE LLC FA0010838 1666 RAMONA 1 2 0 0 0 0 0 0 416080 AutoZone Inc FA0017495 1401 W Grand Ave 4 0 0 0 4 0 1 0 417497 B3 GROVER PARTNERS-C/O TAMMI
JASI
FA0010787 200 S 13TH 2 0 0 0 2 0 0 0
413438 BARRON, JUNE FA0010834 251 S 16TH ST 1 2 0 0 0 0 0 0 416334 BCC CORPORATION FA0010733 1510 BRIGHTON 2 0 0 0 2 0 0 0 407913 BRADYS COVE APTS-MORIARTY

PROPERTY COMPANY
FA0010817 1425 LONGBRANCH 2 0 0 0 2 0 0 0
406752 BRANCH, CLIFFORD FA0010818 1400 W GRAND AVE 2 0 0 0 2 0 0 0 407816 CA DEPARTMENT OF PARKS AND

REC-OCEANO DUNES DISTRICT
FA0010782 340 JAMES WAY 6 0 0 0 6 0 1 0
410794 CALIFORNIA FINE WIRE FA0017003 800 FARROLL RD 3 2 0 0 1 0 0 0 414900 CALIFORNIA FINE WIRE COMPANY FA0017195 338 S 4TH ST 6 0 0 0 6 0 0 0 412106 CENTRAL COAST WATER

TREATMENT
FA0017378 966 HUBER ST 1 0 0 0 1 0 0 0
415770 CENTRAL DRYWALL INC FA0010823 245 BECKETT PL 1 0 0 0 1 0 0 0 415653 CENTRAL PACIFIC INSURANCE FA0010810 480 W GRAND AVE 2 0 0 0 2 0 0 2 384270 CHIANG, KENNETH FA0017140 1591 W GRAND AVE 1 0 0 0 1 0 0 0 410491 CITY OF GROVER BEACH FA0017303 154 S 8TH ST 38 0 0 0 38 0 7 15 416944 COASTAL COMMUNITY BUILDERS,
INC
FA0017704 402 W GRAND AVE 3 3 0 0 0 0 0 0
416697 C/O CALIFORNIA PROPERTY

SERVICES
FA0015823 1364 MENTONE AVE 1 0 0 0 1 0 0 0
413806 COUNTY OF SAN LUIS OBISPO -

MAINTENANCE
FA0013288 976 OSOS ST # 207 2 0 0 0 2 0 0 0
409302 COUNTY SUPERIOR COURT

BUILDING-GROVER BEACH - JCC

CUSTOMER SUPPORT CENTER
FA0010815 214 S 16TH ST 1 0 0 0 1 0 0 0
413945 COYOTE CORPORATION FA0010830 1161 HIGHLAND 3 0 0 0 3 0 0 0 407316 CYPRESS PLANNED DEVELOPMENT
HOA
FA0010833 1691 LONGBRANCH AVE 2 4 0 0 0 0 0 0
413559 DIAS, BOB FA0007209 320 W GRAND AVE 2 0 0 0 2 0 0 0 412357 D. LE SAGE FA0010795 319 N HWY 1 1 0 0 0 1 0 0 0 406133 ELSA MORADO FA0010780 1206 BADEN 1 0 0 0 1 0 0 0 384521 ENGEN ENTERPRISES, INC FA0017435 1500 W GRAND AVE 4 0 0 0 4 0 0 0 416831 FAMILY CARE NETWORK, INC. FA0010778 875 LONGBRANCH 2 0 2 0 2 0 0 0 413789 FIELDER, JOHN FA0017345 262 S 4TH ST 3 0 0 0 3 0 0 0 417235 FIVE SEASONS HOA FA0014354 676 N 12TH ST 1 0 0 0 1 0 0 0 360451 FORDE, JOHN B FA0010799 960 GRAND AVE 2 0 0 0 2 0 0 0 406769 FORDE, JOHN B. FA0010828 968 W GRAND 1 0 0 0 1 0 0 0 409125 FORDE PROPERTIES &

CONSTRUCTION
FA0010812 391 FRONT ST 5 0 0 0 5 1 1 0
416678 GRESS, DAVID R. FA0010840 1151 W GRAND 1 0 0 0 1 0 0 1

Page 1 of 12 ends

Refer to the end of the report for a list owners and sites where all remaining assemblies were inactivated Assembly Types
414199 GROVER BEACH BUSINESS PARK FA0011456 998 HUSTON 1 1 0 0 1 0 0 1 413738 GROVER BEACH MINI STORAGE FA0012825 931 GRIFFIN 1 0 0 0 1 0 0 0 384535 GROVER BEACH PETROLEUM, INC FA0017453 1284 W GRAND AVE 5 0 0 0 5 0 0 0 417417 GROVER BEACH PLAZA-ALAN
PORTER
FA0010835 1511 W GRAND 2 0 0 0 2 0 0 0
410523 GROVER BUSINESS PARK-SIMON
HAKKER
FA0010824 1030 HUSTON ST 1 0 0 0 1 0 0 1
416751 GROVER CITY PLAZA-BARRY

ZARRABIAN
FA0010792 1585 S COAST HIGHWAY APT
65 1 0 0 0 1 0 0 0
413018 HANDLEY, K / GOLDEN SENECA INC FA0017125 1550 W GRAND AVE 4 1 0 0 3 0 0 0 410024 JANET GONG FA0017691 760 N 12TH ST 1 0 0 0 1 0 0 1 417118 JEHOVAH'S WITNESS FA0010831 1279 S 13TH ST 1 0 0 0 1 0 0 0 414828 JOHN FORDE FA0005267 170 W GRAND AVE 2 0 0 0 2 0 0 0 415868 KERRE McCALL FA0014445 910 HUSTON ST 3 0 0 0 3 0 0 0 413173 KHUSHAL INVESTMENTS LLC FA0010801 1800 E GRAND AVE L 2 0 0 0 2 0 0 0 410303 KOEPF, JOHN FA0010803 204 W GRAND 3 0 0 0 3 0 0 0 411994 LONDON, MARK FA0010804 153 8TH ST 3 0 0 0 3 0 0 0 412395 LONGBRANCH APTS FA0010816 1425 LONGBRANCH 2 0 0 0 2 0 0 0 411601 LONG OAK HOA-MANDERLEY

MANAGEMENT
FA0010789 LONGBRANCH 2 0 0 0 2 0 0 0
412781 LUCIA MAR UNIFIED SCHOOL DIST FA0017146 602 ORCHARD ST 3 0 0 0 3 0 0 0 415099 MCELRATH ENTERPRISES FA0010839 111 NEWPORT 1 0 0 0 1 0 0 0 413935 MD ATKINSON COMPANY FA0010808 1600 W GRAND 1 0 0 0 1 0 0 0 413766 MECHANICS BANK ATTN: RNA 91490-
11 FA0010785 899 W GRAND AVE 1 0 0 0 1 0 0 0
384082 MILT GUGGIA FA0017105 777 OAK PARK BLVD 2 0 0 0 2 1 1 0 416026 MINER'S ACE HARDWARE FA0017541 1056 GRAND AVE 3 0 0 0 3 0 1 0 406666 MIR MAR ESTATES HOA-AMERICAN

PROPERTY SERVICES
FA0010779 1327 MIR MAR CT 1 0 0 0 1 0 0 0
411342 NICHOLS, BARBARA FA0010814 1750 EL CAMINO REAL 1 0 0 0 1 0 0 0 410583 OAK PARK CHRISTIAN CHURCH FA0010790 286 N OAK PARK 1 0 0 0 1 0 0 0 412206 OAK PARK VILLAGE-DAVID RENNER FA0010788 251 S OAK PARK 2 0 0 0 2 0 0 0 409999 OCEANVIEW TERRACE-CALIFORNIA

PROPERTY SERVICES
FA0010793 4TH & ROCKAWAY 3 0 0 0 3 0 0 0
406128 OURSTON, DIANA FA0017377 974 GRIFFIN ST 3 0 0 0 3 0 0 0 413487 PATRICK LAIRD FA0015815 1348 MENTONE 1 0 1 0 1 0 0 0 408498 PETERSON, DEBRA FA0010836 160 S 3RD ST 1 2 0 0 0 0 0 0 409149 PISMO/GROVER BEACH RESORTS FA0004259 775 N OAK PARK BLVD 4 0 0 0 4 0 0 0 409902 REHDER, TOM FA0000872 359 W GRAND AVE 2 4 0 0 0 0 0 0 411164 ROCKAWAY CONDOMINIUMS

OWNERS ASSOCIATION
FA0014972 594 ROCKAWAY AVE 3 0 0 0 3 0 0 0
407156 RYKAL/GROVER LLC FA0010800 1580 GRAND AVE 1 0 0 0 1 0 0 0 411403 SARATOGA INVESTMENTS LLC FA0010819 21 SARATOGA 5 0 0 0 5 0 0 0 407942 SEAVIEW INN FA0010783 150 N 5TH STREET 1 0 0 0 1 0 0 0 413751 SINGER, STEVEN FA0010811 148 N 13TH ST 1 0 0 0 1 0 0 0 413170 SLOCAL ROOTS GB FA0002155 923 HUBER ST 3 0 1 0 3 0 0 0 406263 SMITH, CATHI FA0010781 600 GRAND AVE 1 0 0 0 1 0 0 0 408059 STAHL, KARL & VIRGINIA FAMILY
TRUST
FA0010805 160 7TH ST 2 0 0 0 2 0 0 0
410751 THIRD BASE MARKET AND SPIRITS FA0016906 684 W GRAND AVE 1 0 1 0 1 0 2 0 406505 VISTA DEL MAR GROVER BEACHZIERMAN PLUMBING, INCFA0010809 365 8TH ST 1 0 0 0 1 0 0 0 409537 VISTA PACIFIC-MFG ENTERPRISES FA0010813 1385 ATLANTIC CITY AVE 101 1 0 0 0 1 0 0 0 414794 WEINBERG, HAROLD-CA. WEST

PROPERTY MANAGEMENT
FA0010796 1471 RAMONA 2 0 0 0 2 1 1 0
415149 WILSON, DENISE FA0010791 1354 TROUVILLE 1 0 0 0 1 0 0 0 415191 YUK L. YUNG TRE ET AL FA0016144 866 S 16TH ST 1 0 0 0 1 0 0 0 406304 ZAFIRIS, SPIRIDON FA0017472 1771 W GRAND AVE 1 0 0 0 1 0 0 0 Total 214 23 5 0 199 4 15 21

Page 2 of 12 ends

Assembly details grouped by owner and site

Type DC DC2 DCDA PVB RP Total
Count 73 1 6 3 132 215
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
200 S. FOURTH STREET
1546 W. BRANCH ARROYO
GRANDE CA 93420-
(408753)
200 S FOURTH (FA0013224)
2984-001 BD0008923 03/08/2024 02/28/2026 N53806 200 S. FOURTH STREET - FIRE LINE - GROVER

BEACH WEST SIDE OF PARKING STRUCTURE
2984-002 BD0008924 03/08/2024 02/28/2026 4363055 200 S. FOURTH STREET - BYPASS - GROVER

BEACH WEST SIDE OF PARKING STRUCTURE
2984-003 BD0008925 03/08/2024 02/28/2026 4499176 200 S. FOURTH STREET - IRRG. - GROVER

BEACH WEST SIDE OF PARKING STRUCTURE
248 N. 14TH STREET
TOWNHOMES HOA 1400

MADONNA ROAD SAN
LUIS OBISPO CA 93405-
(408034)
248 14TH ST (FA0010807)
1839-001 BD0005472 09/13/2024 09/30/2025 N29637 248 14TH STREET, GROVER BEACH-FIRELINEFRONT OF PROPERTY 1839-002 BD0005473 09/13/2024 09/30/2025 3015902 248 14TH STREET, GROVER BEACH-BYPASSFRONT OF PROPERTY 1839-003 BD0009825 09/13/2024 09/30/2025 ABE2097 248 14TH STREET, GROVER BEACH-AT METER 675 W. GRAND 2175 S.

BRADLEY SANTA MARIA
CA 93454- (409589)
675 W GRAND AVE (FA0012249)
2042-001 BD0008220 02/21/2025 12/31/2025 * N32341 675 W. GRAND - FIRE LINE EAST SIDE OF BUILDING OFF 7TH ST.-
2042-002 BD0008221 12/13/2024 12/31/2025 3183770 675 W. GRAND - FIRE LINE BY PASS EAST SIDE OF BUILDING OFF 7TH ST.-
* Assemblies with failed tests
Service Number 2042-001
Last Failed Test 12/13/2024
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
Albertsons 1421

MANHATTAN AVE
FULLERTON CA 92831
(417087)
1758 W Grand Ave (FA0017150)
1842-001 BD0002064 03/13/2024 02/28/2026 W117306 1758 GRAND AVE-GROVER BEACH-EAST SIDE

OF PROPERTY IN PLANTER
1842-002 BD0002065 03/13/2024 02/28/2026 3101243 1758 GRAND AVE-BYPASS-IN PLANTER EAST

SIDE OF PROPERTY
1842-003 BD0002066 03/13/2024 02/28/2026 1887567 VON'S STORE NO. 2560-1758 GRAND AVE, GROVER BEACH @ METER
1842-004 BD0002067 03/04/2025 02/28/2026 66868 1758 GRAND AVE GROVER BEACH-PRODUCE

PREP AREA
1842-005 BD0002068 03/13/2024 02/28/2026 4014A2 1758 GRAND AVE GROVER H2O MACHINE @

FRONT OF STORE
1842-006 BD0002069 03/13/2024 02/28/2026 F8610 1758 GRAND AVE GROVER BEACH PRODUCE

PREP AREA UNDER COUNTER
1842-007 BD0002070 03/13/2024 02/28/2026 790848 1758 GRAND AVE GROVER BEACH -BAKERY 1842-008 BD0002071 03/13/2024 02/28/2026 857369 1758 GRAND AVE GROVER DELI BEHIND

STEAM OVEN
1842-009 BD0002072 03/13/2024 02/28/2026 23805 1758 GRAND AVE GROVER -STARBUCKS SHOP

IN STORE
Anthony Toste 941

GRIFFITH STREET

GROVER BEACH CA
93433- (411993)
941 Griffin St (FA0017171)
1659-001 BD0005460 12/08/2024 12/31/2025 W334517 941 GRIFFITH GROVER BEACH-AT WATER METER

ARROYO HERITAGE LLC
1015 EVY LANE ARROYO
GRANDE CA 93420-
(408980)
1666 RAMONA (FA0010838)
2490-001 BD0005519 09/30/2023 A033883 IRRIGATION LINE-1666 RAMONA, GROVER BEACH
AutoZone Inc 1401 W

GRAND AVE GROVER
BEACH CA 93433 (416080)
1401 W Grand Ave (FA0017495)
2138-001 BD0000558 05/30/2024 05/31/2025 N33209 1401 W. GRAND -GROVER BEACH-FIRELINE -

WEST SIDE OF BLDG

Page 3 of 12 ends

2138-002 BD0000559 05/30/2024 05/31/2025 3250372 1401 W. GRAND -GROVER BEACH-FIRELINE -

WEST SIDE OF BLDG
2138-003 BD0000560 05/30/2024 05/31/2025 3233130 1401 W. GRAND -GROVER BEACH-DOM - WEST

SIDE OF BLDG
2138-004 BD0000561 05/30/2024 05/31/2025 J011422 1401 W. GRAND -GROVER BEACH - IRRG - NW

CORNER OF PROPERTY
B3 GROVER PARTNERSC/O TAMMI JASI 138 W.

BRANCH STREET STE. B

ARROYO GRANDE CA
93420- (417497)
200 S 13TH (FA0010787)
0267-001 BD0005427 01/16/2024 01/31/2026 N0810300
744
AT METER-FRONT OF COMPLEXPROFESSIONAL BLDG.-200 S. 13TH, GROVER BEACH
0267-002 BD0005428 01/16/2024 01/31/2026 129425 AT METER-FRONT OF COMPLEXPROFESSIONAL BLDG.-200 S. 13TH, GROVER BEACH
BARRON, JUNE 135 S

HALCYON ARROYO
GRANDE CA 93420-
(413438)
251 S 16TH ST (FA0010834)
2145-001 BD0005512 08/31/2023 4293670 251 S. 16TH STREET-GROVER BEACH-WEST

SIDE OF BUILDING IN LANDSCAPE
BCC CORPORATION 1262

MURRAY STREET SAN
LUIS OBISPO CA 93405-
(416334)
1510 BRIGHTON (FA0010733)
1977-001 BD0007467 07/18/2024 07/31/2025 N31764 1510 BRIGHTON-GROVER BEACH-FIRELINEFRONT OF PROPERTY 1977-002 BD0005277 07/18/2024 07/31/2025 3119027 1510 BRIGHTON-GROVER BEACH-FRONT OF

PROPERTY
BRADYS COVE APTSMORIARTY PROPERTY
COMPANY 597 AVE OF
FLAGS STE 104 BUELTON
CA 93427- (407913)
1425 LONGBRANCH (FA0010817)
1917-001 BD0005489 04/11/2024 02/28/2026 ACB6151 IN FRONT OF 1425 LONGBRANCH-GROVER BEACH
1917-002 BD0005490 04/11/2024 02/28/2026 ACB5285 IN FRONT OF 1425 LONGBRANCH-GROVER BEACH
BRANCH, CLIFFORD 755

SANTA ROSA STREET,
STE 310 SAN LUIS OBISPO
CA 93401- (406752)
1400 W GRAND AVE (FA0010818)
1918-001 BD0005491 02/09/2024 02/28/2026 B5212 1400 W. GRAND - GROVER BEACH-SW CORNER

OF PROPERTY AT ENTRANCE
1918-002 BD0005492 02/09/2024 02/28/2026 V5189 1400 W. GRAND - GROVER BEACH-SW CORNER

OF PROPERTY AT ENTRANCE

CA DEPARTMENT OF

PARKS AND REC-OCEANO
DUNES DISTRICT 340
JAMES WAY SUITE 270
PISMO BEACH CA 93449-
(407816)
340 JAMES WAY (FA0010782)
0134-004 BD0006733 02/28/2024 02/28/2026 3956053 OCEANO DUNES PARK-BETWEEN GOLF

COURSE AND RESTAURANT
0134-012 BD0009833 02/28/2024 02/28/2026 ACC8507 WEST WALL OF RESTROOM BLDG - ACROSS

FROM FINN'S
0551-001 BD0005447 02/28/2024 02/28/2026 A001955 LE SAGE R.V. DUMP STATION-PISMO DUNES

DISTRICT, GROVER BEACH
0551-002 BD0005448 02/27/2024 02/28/2026 759422 LESAGE 10' WEST OF METER -R.V. DUMP STATION-RT. OF MT-PISMO DUNES DISTRICT,

GROVER BEACH
0551-003 BD0005449 02/27/2024 02/28/2026 A243910 LE SAGE R.V. DUMP STATION AT METEROCEANO DUNES DISTRICT, GROVER BEACH 0551-004 BD0005450 02/27/2024 02/28/2026 J000452 LE SAGE R.V. DUMP -AT ELECTRICAL PANEL 6' HIGH @ SIDEWALK, GROVER BEACH

CALIFORNIA FINE WIRE
338 S. 4TH ST GROVER
BEACH CA 93433-
(410794)
800 FARROLL RD (FA0017003)
1634-001 BD0005458 11/30/2025 D03818 800 FARROLL RD, GROVER BEACH-NE

CORNER OF PROPERTY NEAR GRIFFIN
1634-002 BD0005459 11/30/2025 585163 800 FARROLL ROAD, GROVER BEACH-NEAR NE

CORNER OF PROPERTY NEAR GRIFFIN
1634-003 BD0010521 11/27/2024 11/30/2025 A018248 BACK PARKING LOT NEAR DOMESTIC WATER

SERVICE

CALIFORNIA FINE WIRE
COMPANY 338 S. 4TH

STREET GROVER BEACH
CA 93433 (414900)
338 S 4TH ST (FA0017195)
0103-001 BD0000003 06/27/2024 06/30/2025 B0019 S.E. CORNER OF BLDG. - 338 S. 4TH ST.,

GROVER BEACH
0103-002 BD0000004 06/27/2024 06/30/2025 A9796 S.E. CORNER OF BLDG. - 338 S. 4TH ST.

GROVER BEACH
0103-003 BD0000005 06/27/2024 06/30/2025 W7426 LANDSCAPE - MANHATTAN ST. -GROVER BEACH
0103-004 BD0000006 06/27/2024 06/30/2025 NOT

LEGIBLE
METER PROTECTION - OFF MANHATTAN ST.,

GROVER BEACH
0103-005 BD0000007 06/27/2024 06/30/2025 U4013 FIRELINE BYPASS- OFF MANHATTAN ST. -

GROVER BEACH
0103-006 BD0000008 06/27/2024 06/30/2025 B4042 FIRELINE-OFF MANHATTAN ST. - GROVER BEACH

CENTRAL COAST WATER
TREATMENT 966 HUBER

ST GROVER BEACH CA
93433 (412106)
966 HUBER ST (FA0017378)
1783-001 BD0000549 06/27/2024 06/30/2026 A211228 966 HUBER GROVER BEACH - FRONT OF

PROPERTY

Page 4 of 12 ends

CENTRAL DRYWALL INC
245 BECKET PLACE

GROVER BEACH CA
93433- (415770)
245 BECKETT PL (FA0010823)
1975-001 BD0005498 06/27/2024 07/31/2025 235892 245 BECKETT PLACE-GROVER BEACH-FRONT

OF BUILDING

CENTRAL PACIFIC
INSURANCE 1300 PRICE

STREET PISMO BEACH CA
93449- (415653)
480 W GRAND AVE (FA0010810)
1848-001 BD0005476 11/09/2024 09/30/2025 2970460 480 W. GRAND AVE GROVER BEACH-BYPASSIN RISER CLOSET 1848-002 BD0005477 11/09/2024 09/30/2025 V18568 480 W. GRAND AVE GROVER BEACH-IN RISER CLOSET

CHIANG, KENNETH
CHIANG YAO HUNG 1591

W GRAND AVE GROVER
BEACH CA 93433 (384270)
1591 W GRAND AVE (FA0017140)
1034-001 BD0000018 05/22/2024 05/31/2026 R2427 1591 GRAND - GROVER BEACH - IRRIGATION - 10 FT FROM METER

CITY OF GROVER BEACH
154 S. 8TH ST GROVER
BEACH CA 93433-
(410491)
154 S 8TH ST (FA0017303)
0247-001 BD0000019 12/09/2024 06/30/2025 J05028 NEAR METER AT OLD PUMP SITE-16TH & MENTONE-G.C. PARK, GROVER BEACH
0247-002 BD0000020 06/30/2024 06/30/2025 AJ0490 LT. OF BUS BENCH-RAMONA & GARDEN PARK,

GROVER BEACH
0247-003 BD0007963 06/25/2024 06/30/2025 H12224 MEDIAN STRIP - OAK PARK AND DRIFTWOOD 0247-004 BD0000021 06/29/2024 06/30/2025 AK3410 ON BANK MIDWAY & REAR OF PARK-8TH &

ATLANTIC CITY STREET, GROVER BEACH
0247-005 BD0000022 06/25/2024 06/30/2025 J47213 ACROSS FROM 201 ANITA STREET-GOLDEN

WEST, GROVER BEACH
0247-006 BD0000023 06/26/2024 06/30/2025 J003435 CAPISTRANO AND OAK PARK-GROVER BEACH 0247-007 BD0000024 06/26/2024 06/30/2025 J006117 MEDIAN STRIP-OAK PARK & MENTON,

GROVER BEACH
0247-008 BD0000026 07/01/2024 06/30/2025 A37571 14TH & TROUTVILLE, GROVER BEACH 0247-009 BD0009389 06/24/2024 06/30/2025 W123638 9TH & GRAND MEDIAN STRIP AT POST OFFICE, GROVER BEACH ** TESTER GET MODEL #****
0247-010 BD0000027 06/26/2024 06/30/2025 S5636 MEDIAN STRIP-OAK PARK & LONG BRANCH,

GROVER BEACH
0247-011 BD0000028 06/24/2024 06/30/2025 Q8655 MEDIAN STRIP-16TH & LONG BRANCH,

GROVER BEACH
0247-012 BD0000029 06/30/2024 06/30/2025 J004570 METER AT CORNER OF 9TH & ROMANA,

GROVER BEACH
0247-016 BD0000031 07/01/2024 06/30/2025 A196829 IN UTILITY PASSAGE-CO. COMMUNITY CTR, 1230 TROUVILLE AVE., GROVER BEACH
0247-017 BD0000032 06/29/2024 06/30/2025 AK3687 GROVE HEIGHTS PARK, N. 8TH ST. AND

ATLANTIC CITY-GROVER BEACH
0247-018 BD0000033 06/30/2024 06/30/2025 A126937 NITRATE REMOVAL PLANT-16TH & NICE,

GROVER BEACH
0247-019 BD0000034 06/25/2024 06/30/2025 AB1498 13TH & LA SELVA, GROVER BEACH 0247-023 BD0000036 06/29/2024 06/30/2025 J098169 AT METER TOP OF HILL-907 5TH-GROVER BEACH
0247-024 BD0000037 07/01/2024 06/30/2025 A105610 10TH STREET & BRIGHTON AVENUE, GROVER BEACH
0247-025 BD0000038 06/24/2024 06/30/2025 A176585 SO. COUNTY SKATE PARK-1700 BLOCK

RAMONA, GROVER BEACH
0247-026 BD0000039 07/01/2024 06/30/2025 A008760 701 ROCKAWAY AVE GROVER BEACH- WEST

SIDE OF FIRE STATION
0247-027 BD0000040 07/01/2024 06/30/2025 98101413
39 701 ROCKAWAY GROVER BEACH-WEST SIDE

OF BUILDING
0247-028 BD0000041 07/01/2024 06/30/2025 A0262719 701 ROCKAWAY GROVER BEACH-SOUTH SIDE

OF BUILDING ON ROCKAWAY
0247-029 BD0000042 07/01/2024 06/30/2025 MISSING 711 ROCKAWAY GROVER BEACH-SOUTH SIDE

OF BUILDING
0247-030 BD0000043 07/01/2024 06/30/2025 014147 711 ROCKAWAY GROVER BEACH-SOUTH SIDE

OF BUILDING
0247-032 BD0000044 07/01/2024 06/30/2025 H003624 ATLANTIC CITY AND OAK PARK BLVD NW

CORNER OF INTERSECTION
0247-034 BD0000045 06/29/2024 06/30/2025 A04435 GROVER BEACH-AT W. GRAND AND OAK PARK

IN LNDSCP BY CITY WELCOME SIGN
0247-036 BD0000047 06/29/2024 06/30/2025 3275934 170 GRAND - GROVER BEACH - IRRG. 0247-037 BD0000048 07/01/2024 06/30/2025 J014842 GROVER BEACH - NW CORNER OF 13TH AND LONGBRANCH @ BUS STOP
0247-038 BD0000049 06/30/2024 06/30/2025 MISSING T. OF BUS BENCH-RAMONA & GARDEN PARK,

GROVER BEACH
0247-039 BD0000050 07/01/2024 06/30/2025 J014682 711 ROCKAWAY -GROVER BEACH-AT

EMPLOYEE ENTRANCE
0247-040 BD0007965 07/01/2024 06/30/2025 3828089 711 ROCKAWAY - AT POLICE STATION 0247-041 BD0007964 06/30/2024 06/30/2025 A041350 16TH & NICE AT BASEBALL DIAMOND

Page 5 of 12 ends

0247-043 BD0008031 07/10/2024 06/30/2025 N0507 COMMUNITY CENTER 1230 TROUVILLE -

FIRELINE - SW CORNER OF PROPERTY
0247-044 BD0008032 07/10/2024 06/30/2025 1362454 COMMUNITY CENTER 1230 TROUVILLE -

BYPASS - SW CORNER OF PROPERTY
0247-046 BD0007982 06/29/2024 06/30/2025 J035863 OCEANO DUNES STATE PARK-25 W. GRAND

NEAR DRIVEWAY ENTRANCE TO PARK IN

LANDSCAPE
0247-047 BD0005444 06/29/2024 06/30/2025 A029467 GROVER BEACH AMTRAK STATION-180 W GRAND AVE-GRAND AVE & HWY 1, GROVER
BEACH
0247-048 BD0005445 06/29/2024 06/30/2025 J038076 GROVER BEACH AMTRAK STATION-180 W GRAND AVE-PARKING LOT S. END OF
STATION-GRAND AVE & HWY 1, GROVER
BEACH
0247-049 BD0005446 06/29/2024 06/30/2025 A178976 GROVER BEACH -HIGHWAY 1 AND LE SAGE-E SIDE OF HIGHWAY 1 IN LANDSCAPE

COASTAL COMMUNITY
BUILDERS, INC 330 JAMES

WY PISMO BEACH CA
93449 (416944)
402 W GRAND AVE (FA0017704)
4473-001 BD0010882 02/10/2025 04/30/2026 V
ACA02458
West Exterior
4473-002 BD0010947 04/22/2025 04/30/2026 N2410070
855
Fire Line Backflow
4473-003 BD0010948 04/22/2025 04/30/2026 182798 Southwest side of building next to fire line OS&Y

C/O CALIFORNIA

PROPERTY SERVICES
1200 PRICE STREET
PISMO BEACH CA 93449-
(416697)
1364 MENTONE AVE (FA0015823)
3237-001 BD0005508 07/01/2024 07/31/2025 ABG3448 1364 MENTONE-GROVER BEACH-L. SIDE OF

DRIVEWAY

COUNTY OF SAN LUIS

OBISPO - MAINTENANCE
976 OSOS ST # 207 SAN
LUIS OBISPO CA 93408
(413806)
976 OSOS ST # 207 (FA0013288)
0120-034 BD0000546 10/30/2024 12/31/2025 3052670 16TH ST. SIDE LEFT OF ENTRY - PLC03-286 SO. 16TH STREET, GROVER
0120-041 BD0000547 10/30/2024 12/31/2025 W192721 PKG LOT SIDE OF BLDG., L-CORN PLC04-1523

LONGBRANCH, GROVER BEACH

COUNTY SUPERIOR
COURT BUILDINGGROVER BEACH - JCC

CUSTOMER SUPPORT
CENTER 2860 GATEWAY
OAKS DRIVE #400
SACRAMENTO CA 95833-
(409302)
214 S 16TH ST (FA0010815)
2770-001 BD0005486 11/20/2024 11/30/2025 A009661 214 S. 16TH STREET GROVER BEACH, NORTH

SIDE OF COURT BUILDING

COYOTE CORPORATION
PO BOX 1026 SAN LUIS
OBISPO CA 93406-
(413945)
1161 HIGHLAND (FA0010830)
2075-001 BD0005504 02/14/2024 02/28/2026 N31340 1161-1165 HIGHLAND-GROVER BEACHFIRELINE-FRONT OF PROPERTY 2075-002 BD0005505 02/14/2024 02/28/2026 3099655 1161-1165 HIGHLAND-GROVER BEACHFIRELINE BYPASS-FRONT OF PROPERTY 2075-003 BD0005506 02/14/2024 02/28/2026 AA1143 1161-1165 HIGHLAND-GROVER BEACHIRRIGATION-W. SIDE OF PROPERTY

CYPRESS PLANNED
DEVELOPMENT HOA 1691

LONGBRANCH AVE

GROVER BEACH CA
93433- (407316)
1691 LONGBRANCH AVE (FA0010833)
2143-001 BD0005510 07/31/2023 W124366 1623 LONGBRANCH GROVER BEACH-IN LANDSCAPE NEAR 1623 LONGBRANCH
2143-002 BD0005511 07/31/2023 J002336 1773 OAK PARK GROVER BEACH-IRRIG-NEAR 1773 OAK PARK-IN LANDSCAPE
DIAS, BOB 2737 COMET

LANE ARROYO GRANDE
CA 93420- (413559)
320 W GRAND AVE (FA0007209)
2218-001 BD0000562 02/13/2024 02/28/2026 R1255 320 W. GRAND - GROVER BEACH - DOM -

ALONG GRAND IN PLANTER
2218-002 BD0000563 02/13/2024 02/28/2026 AA4839 320 W. GRAND - GROVER BEACH - IRRG - E.

SIDE OF PROPERTY IN PLANTER
D. LE SAGE 319 NORTH
HWY 1 GROVER BEACH
CA 93433- (412357)
319 N HWY 1 (FA0010795)
0379-001 BD0005440 06/14/2024 06/30/2026 J018857 W. ENTRANCE TO PARK IN ABV. GRADE BX-319 NO. HIGHWAY 1, GROVER BEACH
ELSA MORADO 1206

BADEN GROVER BEACH
CA 93433- (406133)
1206 BADEN (FA0010780)
0124-001 BD0005422 07/29/2024 04/30/2026 88674 1206 BADEN-RIGHT SIDE OF DRIVEWAY ON

IRRIGATION, GROVER BEACH

ENGEN ENTERPRISES,
INC 31192 LA BAYA DR
STE #B WESTLAKE
VILLAGE CA 913626393
(384521)
1500 W GRAND AVE (FA0017435)
1914-001 BD0000550 01/05/2024 01/31/2026 3089070 1500 W. GRAND -GROVER BEACH - BYPASS - E.

SIDE OF PROPERTY
1914-002 BD0000551 01/05/2024 01/31/2026 N31177 1500 W. GRAND - GROVER BEACH- FIRELINE

FRONT OF PROPERTY
1914-003 BD0000552 01/05/2024 01/31/2026 J010955 1500 W. GRAND - GROVER BEACH- IRRGFRONT OF PROPERTY 1914-004 BD0000553 01/05/2024 01/31/2026 1803086 1500 W. GRAND - GROVER BEACH- INTERNAL -

AT BEVERAGE SYRUP ROOM

Page 6 of 12 ends

FAMILY CARE NETWORK,
INC. 1255 KENDALL RD

SAN LUIS OBISPO CA
93401- (416831)
875 LONGBRANCH (FA0010778)
0040-003 BD0010568 02/19/2024 02/28/2026 ACA9501 ON IRRIGATION SVC-875 LONGBRANCH,

GROVER BEACH
0040-004 BD0010571 02/20/2024 02/28/2026 J011704 ON IRRIGATION SVC-875 LONGBRANCH,

GROVER BEACH
New assemblies
Service Number 0040-003 0040-004
Type RP RP
Manufacturer WILKINS FEBCO
Model XL2 LF825YA
Size 1.0 1.0
Meter Number
Install Date 04/01/2023 05/01/2023
New or Replace Replace Replace
Replaced BD0005419 BD0005419
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
FIELDER, JOHN 262 S 4TH

ST GROVER BEACH CA
93433 (413789)
262 S 4TH ST (FA0017345)
7090-001 BD0000569 08/01/2024 08/31/2025 N03972 FIRELINE-FRONT OF BLDG. ON 4TH STREET,

GROVER BEACH
7090-002 BD0000570 08/01/2024 08/31/2025 1011741 FIRELINE BYPASS-FRONT OF BLDG. ON 4TH

STREET, GROVER BEACH
7090-003 BD0000571 08/01/2024 08/31/2025 H004129 262 4TH STREET GROVER BEACH - SE SIDE OF

BUILDING
FIVE SEASONS HOA 1400

MADONNA ROAD SAN
LUIS OBISPO CA 93405-
(417235)
676 N 12TH ST (FA0014354)
2670-001 BD0009503 02/23/2024 01/31/2026 J008797 IRRIGATION BEHIND WALL NEXT TO APT

FORDE, JOHN B JOHN B
FORDE PO BOX 412

GROVER BEACH CA
93483- (360451)
960 GRAND AVE (FA0010799)
0710-001 BD0005451 07/16/2024 07/31/2025 D03907 960 GRAND, GROVER BEACH FIRELINE-NW

CORNER OF BLDG IN LANDSCAPE
0710-002 BD0005452 07/16/2024 07/31/2025 605275 960 GRAND, GROVER BEACH FIRELINE-NW

CORNER OF BLDG IN LANDSCAPE
FORDE, JOHN B. PO BOX
412 GROVER BEACH CA
93483- (406769)
968 W GRAND (FA0010828)
2018-001 BD0005501 09/03/2024 09/30/2025 BG7937 968 W. GRAND, GROVER BEACH-REAR OF

BLDGS IN PLANTER

FORDE PROPERTIES &

CONSTRUCTION PO BOX
412 GROVER BEACH CA
93483- (409125)
391 FRONT ST (FA0010812)
1885-001 BD0005479 12/11/2024 12/31/2025 08840 391 FRONT STREET, NE CORNER OF

PROPERTY-FIRELINE BYPASS
1885-002 BD0005480 12/31/2024 12/31/2025 * 105795 391 FRONT STREET, NE CORNER OF

PROPERTY-FIRELINE BYPASS
1885-003 BD0005481 12/11/2024 12/31/2025 H31926 391 FRONT STREET, IN FRONT OF BUILDING 1885-004 BD0005482 12/11/2024 12/31/2025 H36167 373 FRONT STREET, IN FRONT OF BUILDING 1885-005 BD0005483 12/11/2024 12/31/2025 H43102 359 FRONT STREET, IN FRONT OF BUILDING * Assemblies with failed tests
Service Number 1885-002
Last Failed Test 12/11/2024
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
GRESS, DAVID R. 1965

EUCALYPTUS HILL SANTA
BARBARA CA 93108-
(416678)
1151 W GRAND (FA0010840)
2596-001 BD0005521 10/14/2024 09/30/2025 T0621 1151-1199 W. GRAND-IRRIG. EAST SIDE OF

BUILDING

GROVER BEACH
BUSINESS PARK 998
HUSTON STREET STE A.

GROVER BEACH CA
93433- (414199)
998 HUSTON (FA0011456)
1955-001 BD0007476 01/18/2024 10/31/2024 39691 GROVER BEACH BUSINESS PARK-998

HUSTON-GROVER BEACH-IRRIG-SE CORNER

OF PROPERTY IN LANDSCAPE

Page 7 of 12 ends

GROVER BEACH MINI
STORAGE 931 GRIFFIN

GROVER BEACH CA
93433- (413738)
931 GRIFFIN (FA0012825)
2901-001 BD0008570 04/03/2024 04/30/2026 795115 931 GRIFFIN - INSIDE FRONT GATE - NEXT TO

DRIVEWAY

GROVER BEACH

PETROLEUM, INC KAUTZ
CHEVRON 1284 W GRAND

AVE GROVER BEACH CA
93433 (384535)
1284 W GRAND AVE (FA0017453)
1966-001 BD0000554 05/10/2024 05/31/2026 N31806 1284 W. GRAND - GROVER BEACH - AT WEST

ENTRANCE
1966-002 BD0000555 05/10/2024 05/31/2026 3122254 1284 W. GRAND - GROVER BEACH - AT WEST

ENTRANCE
1966-003 BD0000556 05/10/2024 05/31/2026 3113537 1284 W. GRAND - GROVER BEACH - AT WEST

ENTRANCE
1966-004 BD0000557 05/10/2024 05/31/2026 J016447 1284 W. GRAND - GROVER BEACH - FRONT OF

PROPERTY IN LANDSCAPE
1966-005 BD0009336 05/10/2024 05/31/2026 3091570 1284 W. GRAND - GROVER BEACH - WEST

WALL OF CAR WASH MECH ROOM UNDER

SHELVING UNIT
GROVER BEACH PLAZAALAN PORTER PO BOX
668 GUADALUPE CA
93434- (417417)
1511 W GRAND (FA0010835)
2193-001 BD0005513 12/04/2024 12/31/2025 J041405 1511 W. GRAND, GROVER BEACH-IRRIG-IN PLANTER L. SIDE OF DOOR
2193-002 BD0005514 12/04/2024 12/31/2025 849855 1551 W. GRAND, GROVER BEACH-IRRIG-IN

MIDDLE LANDSCAPE MEDIAN

GROVER BUSINESS
PARK-SIMON HAKKER 11

WILDHORSE LANE

ROLLING HILLS ESTATES
CA 90274- (410523)
1030 HUSTON ST (FA0010824)
1976-001 BD0005499 11/16/2024 10/31/2025 H001042 1030 HUSTON GROVER BEACH-SE CORNER OF

PROPERTY IN LANDSCAPE
GROVER CITY PLAZABARRY ZARRABIAN 1585
S. COAST HWY APT 65

LAGUNA BEACH CA
92651- (416751)
1585 S COAST HIGHWAY APT 65 (FA0010792)
0345-001 BD0005435 11/13/2024 11/30/2025 J18330 REAR OF SHOPPING CENTER ON FIRELINE,

GROVER BEACH

HANDLEY, K / GOLDEN
SENECA INC PO BOX 306

ARROYO GRANDE CA
93421 (413018)
1550 W GRAND AVE (FA0017125)
0184-001 BD0002060 03/11/2024 02/28/2026 4714164 10 FEET EAST OF FIRELINE-1550 GRAND AVE,

GROVER BEACH
0184-002 BD0002061 03/11/2024 02/28/2026 N26897 1550 W. GRAND AVE, FIRELINE-FRONT OF

PROPERTY-GROVER BEACH
0184-003 BD0002062 03/11/2024 02/28/2026 2796802 1550 W. GRAND AVE-BYPASS-FRONT OF

PROPERTY
0184-005 BD0010898 03/22/2025 02/28/2026 ABA21659 1550 W. GRAND AVE-INTERIOR-BEHIND SYRUP

RACK AT CARBONATOR
JANET GONG 760 N 12TH

ST GROVER BEACH CA
93433 (410024)
760 N 12TH ST (FA0017691)
4472-001 BD0010868 12/13/2024 11/30/2025 ABB06827 next to meter JEHOVAH'S WITNESS 1279
S. 13TH STREET GROVER
BEACH CA 93433-
(417118)
1279 S 13TH ST (FA0010831)
2120-001 BD0005507 05/08/2024 04/30/2026 X5895 1279 S. 13TH STREET GROVER BEACH-NW

CORNER OF PROPERTY
JOHN FORDE PO BOX 412

GROVER BEACH CA
93483- (414828)
170 W GRAND AVE (FA0005267)
2489-001 BD0002073 03/13/2024 03/31/2026 983007 170 GRAND AVENUE-FIRELINE, GROVER BEACH
2489-002 BD0002074 03/13/2024 03/31/2026 D06994 170 GRAND AVENUE-FIRELINE, GROVER BEACH
KERRE McCALL P.O. BOX
1506 ARROYO GRANDE
CA 93421- (415868)
910 HUSTON ST (FA0014445)
2690-001 BD0009555 05/30/2024 05/31/2026 V55225 FIRE LINE - ON HUSTON STREET 2690-002 BD0009556 05/30/2024 05/31/2026 HC33434 FIRE LINE - ON HUSTON STREET 2690-003 BD0009897 05/30/2024 05/31/2026 4850469 NE CORNER - NEAR METER

KHUSHAL INVESTMENTS
LLC 1800 E GRAND AVE #L

GROVER BEACH CA
93433- (413173)
1800 E GRAND AVE L (FA0010801)
0954-001 BD0005456 04/04/2024 04/30/2026 2KL0695 SOUTH SIDE OF MARKET-1800 E GRAND AVE,

GROVER BEACH - UNIT A
0954-002 BD0005457 04/04/2024 04/30/2026 82253 SOUTH SIDE OF MARKET-1800 E GRAND AVE,

GROVER BEACH - UNIT B
KOEPF, JOHN P.O. BOX
3195 PISMO BEACH CA
93448- (410303)
204 W GRAND (FA0010803)
1689-001 BD0005461 03/22/2024 01/31/2026 H000702 NE CORNER OF 228 W. GRAND GROVER

BEACH-IN LANDSCAPE BY RIBLINE
1689-002 BD0005462 03/22/2024 01/31/2026 04998 NE CORNER OF BUILDING-204 W. GRAND

GROVER BEACH
1689-003 BD0005463 03/22/2024 01/31/2026 55335 204 W. GRAND, GROVER BEACH-NE CORNER

OF BUILDING
LONDON, MARK PO BOX 1

ARROYO GRANDE CA
93421- (411994)
153 8TH ST (FA0010804)
1797-001 BD0005464 07/30/2024 06/30/2026 N13184 153 8TH STREET GROVER BEACH-FIRELINEFRONT OF PROPERTY

Page 8 of 12 ends

1797-002 BD0005465 07/30/2024 06/30/2026 W130437 153 8TH STREET GROVER BEACH-BYPASS-IN

FRONT OF PROPERTY
1797-003 BD0005466 07/30/2024 06/30/2026 J073051 153 8TH STREET GROVER BEACH-INSIDE

FENCE FRONT OF PROPERTY
LONGBRANCH APTS P.O.

BOX 6451 LOS OSOS CA
93402- (412395)
1425 LONGBRANCH (FA0010816)
1916-001 BD0005487 01/27/2024 02/28/2026 3061005 SOUTH SIDE OF COMPLEX IN FRONT OF 1425

LONGBRANCH
1916-002 BD0005488 01/27/2024 02/28/2026 3079817 SOUTH SIDE OF COMPLEX IN FRONT OF 1425

LONGBRANCH
LONG OAK HOAMANDERLEY
MANAGEMENT 1400

MADONNA SAN LUIS
OBISPO CA 93405-
(411601)
LONGBRANCH (FA0010789)
0282-001 BD0005431 06/21/2024 06/30/2026 J016112 NEAR UNIT #1641 MANHATTAN-IRRIGATION16TH & LONGBRANCH, GROVER BEACH 0282-002 BD0005432 06/21/2024 06/30/2026 J013250 ON SPRINKLER LINE SVC-1634 LONGBRANCH,

GROVER BEACH

LUCIA MAR UNIFIED
SCHOOL DIST 222

STANLEY AVENUE

ARROYO GRANDE CA
93420- (412781)
602 ORCHARD ST (FA0017146)
0515-011 BD0000051 07/28/2024 07/31/2025 4218090 IN TOTS PLAY YARD WEST OF BLDDGGROVER HEIGHTS SCHOOL, GROVER BEACH 0515-051 BD0000052 07/28/2024 07/31/2025 BK9656 ON LONGBRANCH NEAR 10TH-GOVER BEACH

ELEMENTARY, GROVER BEACH
0515-090 BD0000053 07/28/2024 07/31/2025 L62239 GROVER BEACH ELEMENTARY - IRRG.-S. END

OF CENTRAL BREEZEWAY

MCELRATH ENTERPRISES
3940 BROAD STREET STE.
7, PMB 361 SAN LUIS
OBISPO CA 93401-
(415099)
111 NEWPORT (FA0010839)
2595-001 BD0005520 11/05/2024 11/30/2025 13984 111 NEWPORT-SOUTH SIDE OF PROPERTY IN GRASS

MD ATKINSON COMPANY
1401 19TH ST, STE 400
BAKERSFIELD CA 93301-
(413935)
1600 W GRAND (FA0010808)
1843-001 BD0005474 10/30/2024 10/31/2025 H12905 1600-1608 GRAND-GROVER BEACH-SW

CORNER OF BUILDING
MECHANICS BANK ATTN:

RNA 91490-11 25007 ANZA

DRIVE VALENCIA CA
91355- (413766)
899 W GRAND AVE (FA0010785)
0240-001 BD0005426 06/07/2024 06/30/2026 953508 ON IRRIGATION BEHIND TRASH BIN-899

GRAND AVENUE, GROVER BEACH

MILT GUGGIA AJ SPURS
PO BOX 5459 SANTA
MARIA CA 93456- (384082)
777 OAK PARK BLVD (FA0017105)
0777-001 BD0005454 08/22/2024 08/31/2025 * J000461 AT METER-777 OAK PARK BLVD., GROVER BEACH
0777-002 BD0005455 08/06/2024 08/31/2025 3819401 6" FROM S.W. CORNER OF BLDG-777 OAK

PARK BLVD, GROVER BEACH
* Assemblies with failed tests
Service Number 0777-001
Last Failed Test 08/06/2024
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location

MINER'S ACE HARDWARE
1056 GRAND AVE.

GROVER BEACH CA
93433- (416026)
1056 GRAND AVE (FA0017541)
0972-007 BD0005516 05/22/2024 05/31/2026 A162654 1056 GRAND AVE, METER PROTECTION-11TH

STREET, GROVER BEACH
0972-008 BD0005517 05/22/2024 05/31/2026 B4221 1056 GRAND AVE, FIRELINE-OFF 10TH STREET

IN PLANTER, GROVER BEACH
0972-009 BD0005518 05/22/2024 05/31/2025 U7329 1056 GRAND AVE, FIRELINE-OFF 10TH STREET

IN PLANTER, GROVER BEACH
MIR MAR ESTATES HOAAMERICAN PROPERTY
SERVICES P.O. BOX 853
TEMPLETON CA 93465-
(406666)
1327 MIR MAR CT (FA0010779)
0104-002 BD0010520 04/29/2024 04/30/2026 234794 ON IRRIGATION NEAR CONTROLLER- SOUTH SIDE OF 610 MIR MAR CT., GROVER BEACH
NICHOLS, BARBARA 7

PASEO LADERO LANE
PISMO BEACH CA 93449-
(411342)
1750 EL CAMINO REAL (FA0010814)
1901-001 BD0005485 04/22/2024 03/31/2026 J002474 AT PARKING LOT ENTRANCE TO 1750 EL

CAMINO REAL, GROVER BEACH

OAK PARK CHRISTIAN
CHURCH 386 N. OAK PARK

BLVD GROVER BEACH CA
93433- (410583)
286 N OAK PARK (FA0010790)
0329-001 BD0005433 11/28/2024 11/30/2025 H005497 286 N. OAK PARK-386 N. OAK PARK, GROVER BEACH

OAK PARK VILLAGE-DAVID
RENNER 251 S. OAK PARK
BLVD. GROVER BEACH CA
93433- (412206)
251 S OAK PARK (FA0010788)
0276-001 BD0005429 08/10/2024 08/31/2025 04684 251 SO. OAK PARK, GROVER BEACH 0276-002 BD0005430 08/10/2024 08/31/2025 W004973 251 SO. OAK PARK, GROVER BEACH

Page 9 of 12 ends

OCEANVIEW TERRACECALIFORNIA PROPERTY
SERVICES 1200 PRICE

STREET PISMO BEACH CA
93449- (409999)
4TH & ROCKAWAY (FA0010793)
0364-001 BD0005436 09/11/2024 09/30/2025 J006591 SW CORNER NEAR TRASH ENCLOSURE IN

BUSHES - BELOW SPRINKLER CONTROL BOX

ON WALL
0364-002 BD0005437 09/11/2024 09/30/2025 2181948 SW CORNER OF S. FOURTH STREET AND

ROCKAWAY-GROVER BEACH NEAR TRASH

ENCLOSURE
0364-003 BD0005438 09/11/2024 09/30/2025 V05436 SW CORNER OF S. FOURTH STREET AND

ROCKAWAY-GROVER BEACH NEAR TRASH

ENCLOSURE
OURSTON, DIANA 974

GRIFFIN ST GROVER
BEACH CA 93433 (406128)
974 GRIFFIN ST (FA0017377)
0261-001 BD0000013 06/21/2024 06/30/2026 J016323 974 GRIFFIN - GROVER BEACH - NORTH WEST

SIDE OF PROPERTY BY HUBER
0261-002 BD0000014 06/21/2024 06/30/2026 N29699 974 GRIFFIN - GROVER BEACH - SW SIDE OF 974 PARK BY HUBER ST
0261-003 BD0000015 06/21/2024 06/30/2026 3018504 974 GRIFFIN - GROVER BEACH - SW SIDE OF 974 PARK BY HUBER ST
PATRICK LAIRD 606

SWEET PEA PL ENCINITAS
CA 92024- (413487)
1348 MENTONE (FA0015815)
3236-002 BD0010678 07/17/2024 07/31/2025 ABA69795 1348 MENTONE-GROVER BEACH-R. SIDE OF

DRIVEWAY
New assemblies
Service Number 3236-002
Type RP
Manufacturer WILKINS
Model 975XL
Size 0.75
Meter Number
Install Date 06/30/2024
New or Replace Replace
Replaced BD0005509
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
PETERSON, DEBRA 160 S
3RD STREET GROVER
BEACH CA 93433-
(408498)
160 S 3RD ST (FA0010836)
2232-001 BD0005515 05/31/2023 1221541 160-164 S 3RD STREET, GROVER BEACH -

IRRIGATION-UNDER STAIRWELL

PISMO/GROVER BEACH
RESORTS 775 N OAK

PARK BLVD GROVER
BEACH CA 93433 (409149)
775 N OAK PARK BLVD (FA0004259)
0506-001 BD0000009 03/29/2024 03/31/2026 3052535 IRRIGATION NW CORNER OF CHABLIS BUILDING - 775 OAK PARK BLVD., GROVER
BEACH
0506-002 BD0000010 03/29/2024 03/31/2026 C3111 FIRELINE - 775 OAK PARK BLVD., GROVER BEACH
0506-003 BD0000011 03/29/2024 03/31/2026 3946785 S.W. CORNER OF MAIN BLDG. - 775 OAK PARK.,

GROVER BEACH
0506-004 BD0000012 03/29/2024 03/31/2026 0513 S.W. CORNER OF MAIN BLDG-775 OAK PARK BLVD. GROVER BEACH
REHDER, TOM 359 W

GRAND AVE GROVER
BEACH CA 93433 (409902)
359 W GRAND AVE (FA0000872)
1623-001 BD0000016 09/30/2023 3759128 359 W. GRAND - IN FRONT OF BUILDING IN

LANDSCAPE
1623-002 BD0000017 09/30/2023 J003671 359 W. GRAND - IN FRONT OF BUILDING IN

LANDSCAPE

ROCKAWAY

CONDOMINIUMS OWNERS
ASSOCIATION P.O. BOX
758 GROVER BEACH CA
93483- (411164)
594 ROCKAWAY AVE (FA0014972)
3147-001 BD0009866 03/15/2024 03/31/2026 V45756 NW CORNER OF PROPERTY 3147-002 BD0009867 03/15/2024 03/31/2026 4198484 NW CORNER OF PROPERTY 3147-003 BD0009868 03/15/2024 03/31/2026 J037798 NE CORNER OF PROPERTY

RYKAL/GROVER LLC PO
BOX 360678 LOS
ANGELES CA 90036-
(407156)
1580 GRAND AVE (FA0010800)
0716-001 BD0005453 12/11/2024 12/31/2025 A054988 1580 GRAND AVENUE, GROVER BEACH

SARATOGA INVESTMENTS
LLC 21 SARATOGA AVE

GROVER BEACH CA
93433- (411403)
21 SARATOGA (FA0010819)
1936-001 BD0005493 03/28/2024 03/31/2026 31K0984 21 SARATOGA-WEST SIDE OF BUILDING ON

FRONT STREET
1936-002 BD0005494 03/28/2024 03/31/2026 56708 21 SARATOGA-WEST SIDE OF BUILDING ON

FRONT STREET

Page 10 of 12 ends

1936-003 BD0005495 03/11/2024 03/31/2026 A40174 21 SARATOGA-WEST SIDE OF BUILDING ON

FRONT STREET
1936-004 BD0005496 03/11/2024 03/31/2026 D03924 21 SARATOGA-NORTH SIDE OF BUILDING 1936-005 BD0005497 03/11/2024 03/31/2026 605264 21 SARATOGA-NORTH SIDE OF BUILDING SEAVIEW INN 150 N. 5TH

STREET GROVER BEACH
CA 93433- (407942)
150 N 5TH STREET (FA0010783)
0156-001 BD0005425 07/26/2024 08/31/2025 2001 ON SERVICE SO. SIDE OF BLDG-150 N. 5TH

STREET, GROVER BEACH

SINGER, STEVEN PO BOX
2537 PISMO BEACH CA
93448- (413751)
148 N 13TH ST (FA0010811)
1849-001 BD0005478 11/13/2024 11/30/2025 1452 148 N. 13TH STREET, GROVER BEACH, CAFIRELINE-IN RISER CLOSET SLOCAL ROOTS GB 923

HUBER ST GROVER
BEACH CA 93433-
(413170)
923 HUBER ST (FA0002155)
3362-001 BD0000567 06/13/2024 03/31/2026 MISSING 923 HUBER ST-GROVER BEACH SW CORNER

OF PROPERTY
3362-002 BD0000568 06/13/2024 03/31/2026 W116206 923 HUBER ST - SW CORNER OF PROPERTY 3362-003 BD0010653 06/13/2024 06/30/2025 J59867 FRONT OF BUILDING IN PLANTER New assemblies
Service Number 3362-003
Type RP
Manufacturer FEBCO
Model 825Y
Size 1.0
Meter Number
Install Date 06/13/2024
New or Replace New
Replaced
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
SMITH, CATHI 600 GRAND

AVE GROVER BEACH CA
93433- (406263)
600 GRAND AVE (FA0010781)
0128-001 BD0005423 07/22/2024 07/31/2025 517640 600 GRAND AVENUE, GROVER BEACH

STAHL, KARL & VIRGINIA
FAMILY TRUST 124 S.

HALCYON RD STE. A

ARROYO GRANDE CA
93420- (408059)
160 7TH ST (FA0010805)
1798-001 BD0005467 06/07/2024 06/30/2026 N11010 160 N 7TH STREET GROVER BEACH-IN FRONT

OF PROPERTY
1798-002 BD0005468 06/07/2024 06/30/2026 1657009 160 N 7TH STREET GROVER BEACH-IN FRONT

OF PROPERTY

THIRD BASE MARKET AND
SPIRITS 684 W. GRAND

AVE GROVER BEACH CA
93433- (410751)
684 W GRAND AVE (FA0016906)
4332-001 BD0010661 07/01/2024 06/30/2025 1058351 INSIDE FIRE RISER CLOSET, NORTH WEST

CORNER INSIDE OF BUILDING
New assemblies
Service Number 4332-001
Type RP
Manufacturer WILKINS
Model 975XL
Size 1.25
Meter Number
Install Date 06/28/2024
New or Replace Repair
Replaced
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location

VISTA DEL MAR GROVER

BEACH-ZIERMAN
PLUMBING, INC 2341

MEREDITH LANE SANTA
MARIA CA 93455- (406505)
365 8TH ST (FA0010809)
1847-001 BD0005475 05/30/2024 06/30/2026 2502048 365 8TH STREET, GROVER BEACH-FIRELINEFRONT OF BLDG

Page 11 of 12 ends

Owners and sites where all remaining assemblies were inactivated. Below are the site and inactivated assembly information

There were no owners or sites where all assemblies were inactivated

VISTA PACIFIC-MFG
ENTERPRISES 1385
ATLANTIC CITY STE 101

GROVER BEACH CA
93433- (409537)
1385 ATLANTIC CITY AVE 101 (FA0010813)
1900-001 BD0005484 01/16/2024 01/31/2026 F0304021
106
1385 ATLANTIC CITY-GROVER BEACH-IN

FRONT OF PROPERTY IN LANDSCAPE
WEINBERG, HAROLD-CA.

WEST PROPERTY
MANAGEMENT 145 SO.

HALCYON, STE H ARROYO
GRANDE CA 93420-
(414794)
1471 RAMONA (FA0010796)
0415-001 BD0005441 08/22/2024 06/30/2026 * 1916802 AT DOMESTIC METER-1471 RAMONA, GROVER BEACH
0415-002 BD0005442 07/25/2024 06/30/2026 3636203 REAR OF SOUTH UNIT ON IRRIGATION-1471

RAMONA, GROVER BEACH
* Assemblies with failed tests
Service Number 0415-001
Last Failed Test 07/25/2024
Owner Service No Assembly
ID
Last Passed
Test Date
Due Date Serial
Num
Location
WILSON, DENISE 2090

LAGUNA NEGRA LANE

ARROYO GRANDE CA
93420- (415149)
1354 TROUVILLE (FA0010791)
0337-001 BD0005434 12/20/2024 12/31/2025 F2890 ON SERVICE AT METER-1354 TROUVILLE,

GROVER BEACH
YUK L. YUNG TRE ET AL
2000 N. SANTA MARIA

AVENUE SIERRA MADRE
CA 91024- (415191)
866 S 16TH ST (FA0016144)
3270-001 BD0010254 02/29/2024 01/31/2026 ABR9299 LANDSCAPE - SOUTH SIDE OF GARAGE ZAFIRIS, SPIRIDON P.O.

BOX 250 SANTA MARIA CA
93456- (406304)
1771 W GRAND AVE (FA0017472)
1779-001 BD0000548 04/11/2024 04/30/2026 4721685 1771 W. GRAND GROVER BEACH - SE CORNER

OF PROPERTY ALONG FENCE

Page 12 of 12 ends

City of Grover Beach Cross-Connec7on Hazard Assessment
This survey will help the City of Grover Beach prevent the poten6al contamina6on or pollu6on of the water distribu6on system. Please complete the form below to the best of your ability or contact Billy Haas at (805) 473-4530 for assistance.

Property Informa.on
Property Owner Name Date Form Completed
Street Address Lot Number
City State Zip Code Number of Stories in Structure
1 2
Account Number Provide Phone Number Provide Contact E-mail Check the box if you have any of the following items on your property (check all that apply) Private Well (in or out of use)
Fire Sprinkler System
Swimming Pool
Spa/Hot Tub
Solar Unit using potable water for heat transfer
Water Storage Tank
Lawn Irriga6on System
Drip Irriga6on System
Hose bibs stubbed from House or Garage
Outdoor fountain connected to water system
Other:

Heated Flooring using water
Baseboard Heater using water
Carbonated Beverage Machine
Medical Equipment connected to water
Equipment or Pump Connected to water lines
Automated pet, livestock or poultry watering system
Graywater System interconnected to water supply
Pond or stream supplied by water system
Boiler (not a water heater)
Temporary connec6on to hydrant or wharf head
More than one connec6on to system
Backflow Device(s) Currently Installed
Assembly Type Size Manufacturer & Model Serial Number SLO County Service No.

If you need assistance filling out this survey or if you would like to schedule a free inspec6on by our Cross Connec6on Control Coordinator, please contact Billy Haas at (805) 473-4530.

Please return the completed form to by e-mail a`achment to [email protected] or a printed copy via US Postal Service to 154 S. 8th Street, Grover Beach CA 93433.

Grover Beach City CouncilFebruary 10, 2026

Grover Beach City Council
February 10, 2026