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IOU —, 11N4t <br /> 3.-oa rnihad Sian w/51i� <br /> WELL/PUMP PERMIT <br /> SAN JOAQUIN COONTY ENVIRONMENTAL HEALTH DEPARTMENT 1858Ea5THM5LTONAWNUE-STOCKTONCA95205-(209)466.3420 <br /> NON-REFUNDABLE PERMIT CALL 209 953-7697 FOR INSPECTIONS EXPIRES 1 YEAR FROM DATE ISSUED <br /> JOB Apogees AColiCation 1 of 2: 1181 Zuckerman Rd CnVZP Stockton CA 95206 <br /> CRCS8SnBEET Access Road / <br /> APN 129- -,B12 PARCELSI2E wo Use APPIR:ATION a M <br /> OMERNAMEPaCIfig gag & ElprtrigA .�..,.,,,,rTEF�rren Maeda PHONE (925) 3 -c 3 <br /> OwNeRA00REe3 21 Bollinger Can on Rd CWVITYISTATE¢ San Ramon CA 94583 ,S <br /> COwtrucroa American Construction and Supply Inc PRONE (415) 927-2024 <br /> COWRACTon AOaRee3 45 San Clemente ❑ `v a A- DO C"ISTATe/LP Corte Madera CA 94925 <br /> SuacONmacTOR N/A ptptg <br /> SUBCONTRACTORADDRESa CITY/STATEMP <br /> LICENSE XCd CCEt 'D-09 =Omer NUMBER 310599 EXPIB%MONOATE 03/31/2019 <br /> GEWMMCALINFMMATON: Coordlnab;X 37.988229 Y--!21.479492 TownshlppLN Range 04E Section 25 <br /> Itmxceo Uaa -DomasfiCJPrWate ]Irrlga6oNAHIculural In lhscrsl "Water Guality ManmRing �Soil Sampfing/Chamderaatlan <br /> -Public Water System <br /> nmrtercM mm o.m.� m m. mor r <br /> TWEOFWORN XNew Well =Replacement Well Well AterationiMod lCa9 XOmer Cathodic Protection <br /> Monitoring Wells) 9o mpg XSop galirg(s) so1w'g, Geotechnical a01x,aea` <br /> - <br /> 0u1-01-Service Well Z Out-Ol-Service Well Renewal ❑Cmse-Co mection Repair <br /> - New Pum -Pump Replacement -,Pump Repair r Rabe Wall Casing <br /> WfIL CONSTRUCTON <br /> DHIIMg Method - Mud Rotary -Air Rotary X Auger Cable Tool -Push Paint - DIN, <br /> Proposed Wall Depth 1„5R Ex®vmlion 1_In diameter _Open Bottom - GrgWI PeWGMwi Srza in diameter <br /> _Conduaa Casing N/A odometer I Conductor Casing Depen R <br /> Well Casing Diameter N/A Thickness/Gauge/ASTM SChea N/A Steel C Plastic -.Stainless Steel :Other None <br /> Grout Seal Depen 2 R X Neat Cement(94 lb hagrSlO gal we" Sand Cement sack mkv,?gal water <br /> Bantonite(2(Y%wads) J Oth <br /> Grout Placement Mathad ❑Pumped XFree Fall LOther _Retardant/Accelerator(mnre) <br /> 8111413166 InabNed By X Dmbr L Pump Contractor Omer <br /> Conereta Padeabl-Dimensions:Widen_R Length RThickIn XChdsry Box Sbve%pa <br /> PUMP -SubmarsideL Turbine ❑Omer HP Pump SN R Standing Water Level R <br /> 1 HEREBY CERTIFY THAT 1 HAVE PARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br /> - JOAQUIN COUNTY ORDINANCW, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br /> CURRENT AND ACTIVE WI E CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br /> WORKERS COMPENSATIO{�N�W <br /> E � <br /> P. <br /> MINIMUM 24 L ADVANCE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)l953-7697 <br /> SroxEp Steve McKim ThltE Vice President DATE 04/04/2017 <br /> VC® <br /> 052017 <br /> Cou <br /> MENTAL <br /> NTy <br /> PARTMEIp, <br /> EP1-1 <br /> RTMENT US/E ONLY <br /> Application Accepted By Date y ( p,ea Employee IDP <br /> Grout Impedio Date = SPECIAL Well Perrm t <br /> Pump Inspection By Dote WAIVER Received <br /> Soil Baring Iown B Dfis ComWeted Wall Depen ft <br /> COMMENTS <br /> PE SC Raceivad ChecbN Amount Wb PemdV Invoicaa Well IDM <br /> Coles Ipnb B Caah RemiDad Service unta <br /> 311 �QI qaa 175�(]�11��J� <br /> 17 W00 1 <br /> 7 1ju- J <br /> Eno Alae <br /> 0a+x WElL muta•PT:aw <br /> l�ytss- <br />