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p4"I" SAN JOAQUIN COUNTY r. ENVIRONMENTAL HEALTH DEPARTMENT y 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Office:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd ��FORN WATER WELL NOTICE TO ABATE San Joaquin County Ordinance Code, Title 9 and Title 8,Section 5-5100: It is a violation for any propertyowner to maintain a nuisance in his property. LOCATION: CITY: DATE: i U PROPERTY OWNER NAME: RECORD ID#: TYPE OF INSPECTION: OCOMPLAINT ❑STATUS CHECK ❑OTHER NATURE OF COMPLAINTNIOLATION: o b incl tr yrd o c-tyl cool 7�ti, V,`R. 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. Sic Ord.code,Title 9,Section 9-1115.9—Compliance Required. 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 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 9-1115.8—Prohibited Uses 5. ❑ Lack of or Inadequate Sanitary Seal at Wellhead. SJC 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 CORRECTIVE ACTIONS/ORDERS: ❑ 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 E]Well Repair/Cross Connection ❑Out of Service Well COMPLIANCE DATE: ❑ IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS ❑ 14 DAYS ❑ COMMENTS: COST RECOVERY: All EHD staff time associated with resolving this complaint will be billed at the current hourly rate($125). FAILURE TO COMPLY: Failure to Comply with this Notice May Result in Formal Enforcement Action. APPEAL PROCESS: Any owner or person in possession who objects to the finding of violations cited on this notice may request an office hearing by filing a written request with the San Joaquin County Environmental Health Department within 30 days of receipt of this notice. INSPECTED BY: PHONE: SIGNATURE OF REGISTERED.ENVIRONMENTAL HEALTH SPECIALIST e RECEIVED BY: DATE: "r SIGNATURE Or OWNERITENANT EHD 43-12 10/7/13 WATER WELL NOTICE TO ABATE