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SAN JOAQUIN COUNTY y ENVIRONMENTAL HEALTH DEPARTMENT. 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Office:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd �rFORN WATER WELL NOTICE TO ABATE LOCATION: San Joaquin County ordinance Code, Title 9 C5-10,0 [�leCr'-I(C !fir-: CITY:� /_ DATE:� C k_4LV."? PROPERTY OWNER NAME: 1 RECORD ID TYPE OF INSPECTION: ACOMPLAINT I]STATUS CHECK ❑OTHER. NATURE OF COMPLAINTNIOLATION: VIOLATIONS: It shall be unlawful to maintain or use any residence or place of business which is not in compliance with the i 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. 2 Abandoned Well -not in use; no power source to well; open and unsecured; approved out-of-service well not being 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. s ❑ Approved Out-of-Service Well not being Maintained Properly-well has defects; well acting as conduit for 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 11 5700(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 9-1115.6—Prohibited Uses s• ❑ Lack of or Inadequate Sanitary Seal at Wellhead. sic Ord.Code,Title 9,Section 9-1115.5—,Well Regulations 6. ❑ 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 8• ❑ 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 I. CORRECTIVE ACTIONS/ORDERS: Effective Immediately: K Cease work and obtain an approved permit as indicated below ❑ Cover well with a watertight, secure well cover 5d Obtain permit as indicated: gDestruction ❑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) t COMPLIANCE DATE: ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS ❑ 14 DAYS K � ► ��+�� I COMMENTS: - rYa a.�ecl e.17 1�=� ALL EHD STAFF TIME ASSOCIATED WITH RESOLVING THIS COMPLAINT WILL BE BILLED AT THE CURRENT HOURLY RATE($125) FAILURE TO COMPLY WITH THIS NOTICE MAY RESULT IN FORMAL ENFORCEMENT ACTION INSPECTED BY: � � � .5z PHONE:�,_ JJ 4 SIGNATURE OF REG I ENy ENYAL HEALTH SPECIALIST RECEIVED BY: DATE: SIGNATURE OF OWNERIrENANT EHD 43-12 2/5/13 WATER WELL NOTICE TO ABATE