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WP0037310
EnvironmentalHealth
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037310
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Entry Properties
Last modified
6/27/2018 2:05:26 PM
Creation date
3/14/2018 3:30:26 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037310
PE
4381
FACILITY_NAME
TERRI HOWELL
STREET_NUMBER
14133
Direction
E
STREET_NAME
COLLIER
STREET_TYPE
RD
City
ACAMPO
Zip
95220
APN
02102004
ENTERED_DATE
3/14/2018
SITE_LOCATION
14133 E COLLIER RD
RECEIVED_DATE
9/13/2017
P_LOCATION
99
P_DISTRICT
004
Tags
EHD - Public
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PC .111% WGLL ~ PEF*Ar <br />'W12 <br />WELLIPUMP PERMIT <br />SAN JOAQUIN CowTY ENRARONMENTAL W.ALIW DMAWAMIT 1=lFAXTKA7MTtlMAVE-9O3OnMCA95206 - (209)4694M <br />NON 41EFLNNASI -E PERMT CA' 1 (209) 953-7dS7 Fat kgwecToom ESE I YEM FRM DATE WW" <br />—Zz <br />crrv" <br />Y, 'I <br />21 o <br />oww:R <br />ICO.7RAC.7 19.1 J C C4 1), 9 TL u <br />IV TTI (V <br />SUR=WMICTOR PH= 119 <br />I. IV 171 W"- - <br />lV7FF <br />m <br />j o <br />� SUI3CMMtACTOFt ADM= <br />'z, L t 'y; <br />ju_ V <br />C-57 C-61 609 O—kLl— a^= <br />Coordnat" X Y Tam _ Raupa seemn <br />INTEM= USE V 00naSZdP+Jate frrk3m%wVAgftL&rW VdmtQd W*N Quawy mooftetv SdOW-0-balcharacberhoGo. <br />WSW Syster <br />IfPubkc dftfwt tom n omw WSW 5y$Wfl NWft <br />TYPE OF yYOaz New Well R404cwnwd wel Wd Aftwa6onAlocfficabw cow <br />mwitving wed(s) 9 of web SalS_WV(S) _ 4 of ed, g <br />Out-0fSenice Won Pens" <br />=7�— W46 Mow <br />jow <br />i Dldffig Uwdwd Mid Rotary Air Rotary Auger C2W& Tool Push point Otltr <br />Proposed Well Deem ----ft E=vadon _ n dWmate, op- BaCo a Gft4 PoddGravel Sim— tn aamerer <br />til �I <br />CO du= C-asM _ In dWnmw / Caxkm= QwQ Depth <br />Pbodc : 91 stibal <br />Wen CuaV Diamew _ tn ThidmamG&QWASTM S&Ad _ sbw Otter <br />Depth ft Now cwnvt lb bo�lo wmt@4 Sand conort--soo nwd7 WSW <br />3 <br />Grout Sed (1;4 9w gal <br />Somme (20% SdWs) Om-- — <br />-,--) <br />Grout Pkaeetnent Method Pumped Free FO O&W — PW&dm /Acoodwacrommo <br />PMWA& bubblod By DrAw . Pump Ccr� O&W <br />. . Dk <br />s� P n-mm*onwWklth_ft Length —ftThi*—ln a;w scat ftoweP" <br />SubTws"s TLwbre Odw HP::�ft�=Sd�- V i '-ft ftrdMWsjor <br />PiAlp L" ikK:ft:l <br />f) <br />IHEREBY CERTIFY THAT HA Vg PREPAREDTM APPLICATION AND THAT THE WOW VALL BE OM IN ACCOMMM WITH SAN <br />IOAQUIN STATE LAM AND RIJ�t-YM REGULATIONS- I ALSO ClUff UV MY REM� UCENSE is <br />"U <br />CURRENT Ata? CALFORMA ATE LICENSE BOARD AND TWff I M N COMPLIANCE WITH ALL <br />WOFJKTEZ;mtS <br />$URED FCft <br />f <br />1�j <br />N <br />INIMU R ADVANCE NOTICE INSPECUMS - rW CALL (209) 953-7697 1 <br />M U <br />sic.NED <br />PC .111% WGLL ~ PEF*Ar <br />'W12 <br />
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