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p Waiver <br /> Well Permit Number. Ct\o 07'2,05-0 <br /> 5&41 dePfh <br /> This application is made for a waiver of the minimums ck dikes required by San <br /> Joaquin County Well Standards. <br /> Site Address: 8M West Mossdale Road,Lathrop,CA 95330 <br /> APN: 239-030-080 <br /> This Waiver is requested due to the following circumstances: <br /> The County well ordinance requires a 50 foot seal on irrigation wells. We are requesting to <br /> install a 60 to"foot dee well with 40 to 50 feet of screen.We do not want to cture a clay <br /> layer at greater ep s. Grown ater is approximate y 10 feet gs. a well eusedintermittently <br /> for landscaping We request a variance for a minimum 20 feet seal. <br /> Approved by: Date: <br /> &tmvd Enm Specialist <br /> The following conditions are placed on the well construction permit and may not be <br /> modified- <br /> 1. <br /> odified1. The property owner shall sign this application and acknowledge that the minimum <br /> distance setback deviates from the minimum distance setback of Well Standards. <br /> 1,the undersigned owner of the property identified above,hereby request a Waiver from <br /> the minimum distance setback of San Joaquin County on the information noted above. I <br /> acknowledge that this Waiver information should be disclosed to subsequent property <br /> owners. <br /> Signature ofProperty Owner. <br /> Print Name: ` <br /> Mailing Address: PO Box 1429,Lathrop,CA 95330-1429 <br />