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Pg"I" SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT N t 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Office:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd �/FOR WATER WELL NOTICE TO ABATE San Joaquin County Ordinance Code, Title 9 LOCATION: CITY: DATE: L< PROPERTY OWNER NAME: RECORD ID#: TYPE OF INSPECTION: ❑COMPLAINT ❑STATUS CHECK OTHER NATURE OF COMPLAINT/VIOLATION: .[- VIOLATIONS: It shall be unlawful to maintain or use any residence or place of business which is not in compliance with the 1• ❑ requirements of SJC Ordinance Code,Title 9, Chapter 9-1115 or the SJC Water Well Standards. SJC Ord.Code,Title 9, Section 9-1115.9. Abandoned Well- not in use; no power source to well; open and unsecured; approved out-of-service well not being 2. ❑ maintained; in a state of disrepair; or well casing buried. CA Health&Safety code,Section 115700(a)(b)(d);CA Health&Safety Code,Section 115710;SJC Ord.Code,Title 9,Section 9-1115.5—Well Regulations,SJC Water Well Standards,Section 6.1. Approved Out-of-Service Well not being Maintained Properly-well has defects; well acting as conduit for 3. ❑ contamination of groundwater; well is not properly sealed; well is not marked; well is not kept clear of brush or debris. CA Health&Safety Code,Section 115700(d);SJC Water Well Standards,Section 5.1.—Out of Service Wells. 4. ❑ Provision of Water from Separate Parcel, Use of a Well Pit. SJC Ord.Code,Title 9,Section 9-1115.8—Prohibited Uses 5. ❑ Lack of or Inadequate Sanitary Seal at Wellhead. SJC Ord.Code,Title 9,Section 9-1115.5—Well Regulations s. X Lack of or Inadequate Surface Seal around Well Casing.SJC Water well Standards,Section 4.10. —Surface Seal 7. ❑ Sounding Tube or Air Vent not Sealed. SJC Water Well Standards,Section 4.12.—Sounding Tube/Air Vent Pipe s. ❑ Lack of or Inadequate Sampling Tap. SJC Water well Standards,Section 4.13.—Sampling Tap 9. ❑ Lack of or Inadequate Backflow Prevention. SJC Water Well Standards,Section 4.14.—Backflow Prevention 10 ❑ Work being Conducted without a Permit-construction; destruction; pump; repair; sanitary seal broken; or cross- connection repair. SJC Ord.Code,Title 9,Section 9-1115.3—Well Permit Required CORRECTIVE ACTIONS/ORDERS: Effective Immediately: ❑ Cease work and obtain an approved permit as indicated below ❑ Cover well with a watertight, secure well cover ❑ Obtain permit as indicated: ❑ Destruction ❑Construction ❑ Pump ❑Well Repair/Cross Connection ❑ Out of Service Well (Out of Service wells must meet certain requirements-Contact the Environmental Health Department for details) COMPLIANCE DATE: ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS EF/14 DAYS ❑ COMMENTS: 777zt ALL EHD STAFF TIME ASSOCIATED WITH RESOLVING THIS COMPLAINT WILL BE BILLED AT THE CURRENT HOURLY RATE($125) RE TO COMPLY WITH THIS NOTICE MAY RESULT IN FORMAL ENFORCEMENT ACTION INSPECTED B PHONE: ��'� SIGNAT E OF REGISTERED ENVIRONMENTAL HEALTH SPECIALIST RECEIVED BY: DATE: SIGNATURE OF OWNEFVTENANT EHD 43-12 2/5/13 WATER WELL NOTICE TO ABATE