Laserfiche WebLink
JOB ADDRESS <br />OWNER NAME <br />OWNER ADDRESS <br />CONTRACTOR <br />1901 S Stockton St <br />The Whiting-Turner Contracting Company <br />ory/zip Lodi/95240 <br /> <br />PARCEL SIZE 15-92 Acres LAND USE APPLICATION # <br /> PHONE <br />CITY/STATE/ZIP Sacramento/CA/95811 <br />PHONE 209-655-7541 <br />CROSS STREET Neuharth dr ApN 062-19-027 <br />800 R St <br />West Coast Exploration Inc <br />CONTRACTOR ADDRESS P.O. Box 133 CITY/STATE/ZIP Escalon/CA/95320 <br />SUBCONTRACTOR/CONSULTANT CTE Cal Inc <br /> <br />PHONE 209-543-1799 <br />SUBCONTRACTOR/CONSULTANT ADDRESS 4230 Kiernan Ave Ste 150 CITY/STATE/ZIP Modesto/CA/95356 <br />LICENSE It C-57 0 C-61 0 0-09 0 Other NUMBER 570761 EXPIRATION DATE 1/31/2022 <br />BILLING PARTY: 0 OWNER 0 CONTRACTOR St SUBCONTRACTOR/CONSULTANT <br />0 Conductor Casing in diameter / Conductor Casing Depth ft <br />Grout Placement Method o Pumped a Free Fall ft Other tremie it in Retardant / Accelerator (name) <br />ft Thick <br />PEDESTAL <br />in 0 Christy Box 0 Stove Pipe <br />Installed By 0 Driller 0 Pump Contractor = Other <br />Concrete Pedestal 0Dimensions: Width ft Length <br />ft HP Pump Set ft Standing Water Level PUMP E Submersible 0 Turbine 0 Other <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 ADVANCE NOTICE REQUIRED FOR INSPECTIONS - PLEASE CALL (209) 953-7697 <br />SIGNED ie2mt441 3/1a.61,-;f- TITLE Staff Geologist DATE 3/4/21 <br />WELL CONSTRUCTION <br />Drilling Method 0 Mud Rotary 0 Air Rotary ft Auger 0 Cable Tool 0 Push Point 0 Other <br />Proposed Well Depth 40 ft Excavation 4 inches in diameter 0 Open Bottom 0 Gravel Pack/Gravel Size in diameter <br />Well Casing Diameter in Thickness/Gauge/ASTM Sched 0 Steel 0 Plastic E Stainless Steel 0 Other <br />Grout Seal Depth ft to Neat Cement (94 lb bag/5-10 gal water) 0 Sand Cement <br />0 Bentonite (20% solids) 0 Other <br />sack mix/7 gal water <br />A A <br />SAN <br />VVELLJPUMP 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 />Dom EST1C WELL SAMPLING: 0 General Mineral/Coliform Bacteria (4391) 0 Dibromochloropropane (4392) CI Arsenic (4393) <br />INTENDED USE 0 Domestic/Private 0 Irrigation/Agricultural 0 Industrial 2 Water Quality Monitoring ki Soil Sampling/Characterization <br />2 Public Water System <br />If drfferent from Owner Water System Name Contact Name or Phone Number <br />TYPE OF WORK 0 New Well 0 Replacement Well 0 Well Alteration/Modification 0 Other <br />0 Monitoring Well(s) # of wells 0 Soil Boring(s) *of borings Geotechnical 5 sof borings <br />0 Out-Of-Service Well 0 Out-Of-Service Well Renewal E Cross-Connection Repair <br />E New Pump 0 Pump Replacement 0 Pump Repair 0 Raise Well Casing :SS3LICIOV 311S DEPARTMENT USE ONLY <br /> <br />Application Accepted By Date 3 /SA <br /> <br />Grout Inspection By Date <br />Area LI /5.-r- '.1-12A1 Employee I D# <br />0 SPECIAL Well Permit <br />0 WAIVER Received <br />Constructed Well Depth <br />Pump Inspection By <br />Soil Boring Inspection By <br />COMMENTS <br />Date <br />Date 3/1 Van,/ ft <br />PE <br />Codes <br />SC <br />Info <br />Received Check#1 <br />Cash <br />Amount <br />.Remitted Date Permit/ <br />Service Regqe Invoice # Well ID# <br />E d:K 7o-2 0 <br />13/).76/ <br />1 f-2-/C eA V <br />, <br />I -MO -314iii POO LA 1 <br />CoNit:12-1(014 o(p <br />WELL /PUMP PERMIT END 4346 6111/2019