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p4"Q" SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT T •1 4 N• ;� 1868 East Hazelton Avenue, Stockton, CA 95205-6232 - �q. __ ::•NiP 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 and Title 8, Section 5-5100: It is a violation for any property owner to maintain a nuisance in his property. LOCATION: CITY: DATE: 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 — 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 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 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 ❑ 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 RECEIVED BY: DATE: SIGNATURE OF OWNER/TENANT EHD 43-12 10/7/13 WATER WELL NOTICE TO ABATE