Laserfiche WebLink
139 - <br />yo5 <br />WELL/PUMP PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 600 EAST MAIN STREET -STOCKTON CA 95202 - (209) 4683420 <br />NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br />1 71bou <br />JOB ADDRESS =W W Kile Rd CITYIZ Thornton / 95686 <br />CROSSSTREET N. Nowell Rd APN001-230-45 001-180-24p CEL SIZE � LAND USE APPLICATION# <br />OWNER NAME +Q' PHONE ^ <br />�- F' I K r CITY/STATEI2IP L [I �1 !T <br />OWNER ADDRESS F <br />CONTRACTOR Kleinfelder, Inc. PHONE 209-577-4333 <br />CONTRACTOR ADDRESS 1224 5th Street CITY/STATEZP Modesto / CA / 95354 <br />SUBCONTRACTOR -Z'a J PHONE 91tS-�J7T-873* <br />SUBCONTRACTOR ADDRESSeZdVeMrffZTrffW CITY/STATE/ZIP W <br />LICENSE C-57 C-61 0-09 Other NUMBER ��"TiL-*ru: XPIRATION DATE'��� <br />GEOGRAPHICAL INFORMATION: Coordinates X Y Township_ Range Section_ <br />INTENDED USE DOmestic/PriVate IDdgalion/Agricultural Industrial Water Quality Monitoring <br />Public Water System <br />Ird7remm from Owner. Water System Name Contact Name or Hnone NUMbSr <br />TYPEOF WORK New Well Replacement Well Well Alteralion/Modifrcation Other <br />Monitoring Well(s)—J—#of wells Soil #orbadngs #otbari.gs <br />�XGeotechnical <br />Out -Of -Service Well Out -Of -Service Well Renewal Cross -Connection Repair <br />Drilling Method 4Ed Rota Air Rotary uger Cable Tool Push Point Other <br />Proposed Well Depth 30 8, 50 It Excavation B in diameter Open Bottom Gravel Pack/Gravel Size in diameter <br />Conductor Casing in diameter / Conductor Casing Depth ft <br />Well Casing Diameter _ in Thickness/Gauge/ASTM Sched Steel Plastic Stainless Steel Other <br />Grout Seal Depth R 2f Neat Cement (94 1b bag/610 gal water) Sand Cement sack mixl7 gal water <br />Bentonite (20% solid Other <br />Grout Placement Method Pumped Free Fall Other Retardant / Accelerator (name) <br />PEDESTAL Installed By Driller Pump Contractor Other <br />Concrete Pedestal Dimensions: Width It Length 11 Thick In Christy Box Stove Pipe <br />PUMP Submersible Turbine Other HP Pump Set ft Standing Water Level ft <br />I HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. 1 ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />HOUR ADVANCE NOTICE REQUIRED FOR INSPECTI <br />TITLE Project Enginee� " DAA 10/2/17 <br />rA <br />m <br />0 <br />m <br />N <br />WE <br />�■ 1■■■ <br />■o■■■■■� <br />■oI■■■■■■■■■ <br />- 1■■■ <br />no <br />I■r. I■■■■■■ 1■■■ <br />on <br />r A, 1■■■ <br />I■■r■■■■■■., <br />�, <br />No <br />�-� <br />IMME <br />on o <br />ISI■t1■■■■■■ 1■■■ <br />■�:'. <br />iombE■■■■■ - 1■■■ <br />on _ <br />■� ... a ..; - <br />11111111110111 MEMO .:._ <br />I■■■■■■■■■ <br />I■■■ <br />I■■Mfflk <br />MR <br />■. - <br />■%■■■■■■■ <br />_.IU■■■■■■■■■ <br />INS <br />loom <br />INS■ <br />■■■ <br />■ <br />■ <br />���������J■■■ <br />■■■■■■■moommommomm■`��i !Mmmmmmmmmmmmmmm <br />■■■■■■■■■■■■■■■■■■■■■■■■■■■■ <br />�f <br />apm <br />EHD 43-08 WELL (PUMP PERMIT <br />8104/08 <br />