Laserfiche WebLink
OWNER ADDRESS CITY/STATE/LP Stockton, CA 95202 City Hall, 425 N , El Dorado St <br />LICENSE VC-57 C-61 0-09 Other NUMBER 764878 EXPIRATION DATE 06/30/2021 <br />VSUBCONTRACTORJCONSULTANT OWNER BILUNG PARTY: CONTRACTOR <br />INTENDED USE Domestic/Private Irrigation/Agricultural Industrial Water Quality Monitoring Soil Sampling/Characterization <br />If different from Owner: <br />Public Water System <br />Water System Name <br />Joe ADDRESS 0 E Morada Ln.- GPS: 38.037041 -121.242189 (WORKING RIGHT OF WAY)Crrv/LP Stockton, CA 95212 <br />CROSS STREET <br />N MADELINE DR <br /> APN 085 18011 1(iie4 i) PARCEL SIZE <br />City of Stockton <br />PHONE CONTRACTOR Underground construction Co. 707-741-1761 <br />CONTRACTOR ADDRESS 5145 Industrial Way CITY/STATE/ZIP Benicia, CA 94510 <br />SUBCONTRACTOR/CONSULTANT Corrpro Companies Inc.., 510-509-4993 PHONE <br />OWNER NAME <br />SUBCONTRACTOR/CONSULTANT ADDRESS 2625c Barrington Court CITY/STATE/LP Hayward Ca 94545 <br />DOMESTIC WELL SAMPUNG: General Mineral/Coliform Bacteria (4391) Dibromochloropropane (4392) Arsenic (4393) <br />LAND USE APPLICATION # <br />PHONE <br />Contact Name or Phone Number <br />Other Retardant / Accelerator (name) <br />ft Thick <br />PEDESTAL <br />Stove Pipe in Christy Box <br />Installed By Driller Pump Contractor Other <br />Concrete Pedestal Dimensions: VVidth ft Length <br />ft Standing Water Level ft Pump Set Submersible Turbine Other HP PUMP <br />SIGNED <br />I HEREBY CERTIFY THAT I HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br />JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. I ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br />CURRENT AND ACTIVE WITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br />WORKERS COMPENSATION LAWS. <br />MINIMUM 48 HOUR ADV,..IOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br /> TITLE Construction Manager DATE 01/21/2020 <br />WELL CONSTRUCTION <br />Drilling Method VMud Rotary Air Rotary Auger Cable Tool Push Point Other <br />Proposed Well Depth 200 ft Excavation 8" in diameter Open Bottom 5/Gravel Pack/Gravel Size in diameter <br /> <br />Conductor Casing in diameter / Conductor Casing Depth ft <br />Well Casing Diameter in Thicknes5/Gauge/ASTM Sched Steel Plastic Stainless Steel VOther No Casing <br />Grout Seal .Dlypth_ 100_ ft V Neat Cement (94 lb bag/5-10 gal water) Sand Cement sack mix/7 gal water <br />V Bentonite (20% solids) Other 100'-3'NEAT CEMENT <br />Grout Placement Method Pumped Free Fall <br />dki-eJ 1 <br />S41 <br />Application Accepted By <br />Grout Inspection By <br />Pump Inspection By <br />Soil Boring inspection By <br />COMMENTS Near .5 rnafel <br />S <br />WELL/PUMP PERMIT <br />SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT 1868 EAST HAzELTON AVENUE - STOCKTON CA 95205 -6232 (209) 468-3420 <br />NON-REFUNDABLE PERMIT www.sjgov.org/ehd EXPIRES 1 YEAR FROM DATE ISSUED <br />TYPE OF WORK VNew Well Replacement Well <br />Monitoring Well(s) # of wells <br />Out-Of-Service Well <br />New Pump Pump Replacement <br />Well Alteration/Modification VOther cathodic protection well construction <br />Soil Boring(s) # of borings Geotechnical # of borings <br />Out-Of-Service Well Renewal Cross-Connection Repair <br />Pump Repair Raise Well Casing <br />DEPARTMENT USE ONLY <br />Date <br />Date ki SPECIAL Well Permit <br />Date WAIVER Received <br />Date Constructed Well Depth ft Is cxe-ef <br />Area 1:1/ Employee ID# DA <br />PE <br />Codes <br />SC <br />Info <br />Received Check#/ <br />i Cash , <br />Amount <br />Remitted <br />Permit/ <br />wito Invoiced Well ID# <br />43-71 ) R) 1/7!)-- ---- V./ 5, *3R.S' 2.,RFI erviri Re uest # <br />A , <br />WELL /PUMP PERMIT EHD 43-06 6/11/2019