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FIELD DOCUMENTS
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35500
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4800 – General/Other Program
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PR0508043
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Last modified
5/24/2021 11:19:37 AM
Creation date
5/24/2021 10:29:31 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4800 – General/Other Program
File Section
FIELD DOCUMENTS
RECORD_ID
PR0508043
PE
2960
FACILITY_ID
FA0007905
FACILITY_NAME
CHEVRON PIPELINES
STREET_NUMBER
35500
STREET_NAME
WELTY
STREET_TYPE
RD
City
VERNALIS
Zip
95385
APN
25526003
CURRENT_STATUS
01
SITE_LOCATION
35500 WELTY RD
P_LOCATION
99
QC Status
Approved
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SJGOV\dsedra
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EHD - Public
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g7�07:98 14:50 GREGFr'-�I L-LING*I NS I TU y 5109327130 NU. 754 G02 <br /> ^0- <br /> SAN <br /> r.a- <br /> B IN JOAQUIN i:OUNTT Pumas flRALTH slavicw <br /> PROn (208)488-3U0 <br /> p T MIRM i YFARP D9Tg <br /> (complete iD Triplicate) <br /> I pltCaCi4G 11a hareby aa.de,SO Ilan JeEKtui Coutty for a past to G,jusumuct aid/Or ihaaealS tee torx aarsln degeribdod,. Tb,La <br /> appticat ldn Sm mde 1--n cavuance. vith &W JomCuib Cake&W 6tdir+Aaee No. 549 and 1W and the Rules &W Ite&uutions ot,sw <br /> JoaWn Co%Wt7 Pub21u Se.alth Serv%ces. <br /> job Addres+t G;cy �..._ �'t sixolAersaae �r <br /> cww'a Addra <br /> Hlama �.d :��" f 1 ,�.., ars � �E t►, A* � aft. 9phone <br /> Caniracta r% �I Address1 License No, q pro,. <br /> T'lPar F WP=LLIPV N"WELL 0 WELL REPLAUM€t4T O 0CSTAUCTI0lt 0 04t of SW� see *11 <br /> J PVMP INSTALLATION V SYSTEM AEPAM Q OTHER C mcmitcrYng <br /> k)WANCE TO NEAREST: SEPTIC TANK ! SEWFA UtiES MMSAL FLO, MRCP. UNI <br /> - FOUNDATtON ,_�___ AGRICULTURE WILL — --_... OTNgR WELL— ittT8aSUMPS <br /> INTENOEU USE TYPE OF WELL PROBLEM AA1EA CGNSTR rT1QN SPECIFICATIONS 4 � <br /> 0 indosv�l _._.� G Dp" Bottom 0 Mantas# fat, of Ws11 Excavatiap� --- <br /> ""�_ ._ ' t�iat. of VY®If CsSitrSp � _ <br /> n Bome3ticiplivate �3favei P,.k 0 'CnKv T1 a~�aing C. Spaalfiaail m i <br /> I') Push i"l O:I+er n Do4ta I)epth of Gr&.a 5aa!p, Typa of arout, 4Y <br /> I IrAgat-cos __,Apalrex. ''ZeWh I I t;MWO Surface Serol Instal:ed <br /> Fk"ir Work Done J Type of Dump ff-F_ _ State Work Done -- <br /> WON Oe*1MKVon rJ WeU 014"teter �.. ilateriai i Depth <br /> Depth idler Haterial A Deptkh <br /> TS'PI OF Skf Tl WORK: N tt W INGTAtLATION I i 149PAMI.A004TiON I I p£STAUC'TJON I I (No wok system pemlittW if pra0tio trews+is <br /> oval"within 200 feet,) <br /> Inwsl nwri troll!sane: Aefidsrme— Corns dW„„„_, falter <br /> ,46Wbec of IkVV onrw— Nufl,4w of tedroorm <br /> Cfutwty ct uA to to depth Of S feat: ___ - .—W*W talbit#depth <br /> SIVT4C'YANK 0 Tyfltlii► 9 Capacity No. <br /> PKK. TREATM04T PLT.M Method 41 <br /> DfuraOa ro raaw"t: Weal Foundatioaa,.�_ PlOpaRY Lina�..� <br /> LEACHINCI I.NE 0 No.b Ltrwgth of Mes� — 70tal Wtgthlsizes — <br /> FILTER BED C DivAr a to nfw4w., Wed IsropeRy Line <br /> SEEPAGE PITS I I Depth Number-- <br /> SUMPS I_f L kAwrA to neere€t: Woad _ FW,nc�tltarx ._ — argWty LWWe <br /> _DISPOSAL PONDS 0 <br /> 1 hwtLry cest4 "i I h""o4mo Chis opok,at)and my Ow wwxk w1I be Oona in K;x�nJar+ero with Sbn J4a4uirt t.G1+AW ardiru�tea, star,*aawb, ane <br /> ruins and roguWtKwa of tris San-kw4uin 14wty <br /> HO"10•owtxar or 4icc V4*d sgrra't,648tne ONTIf-ies rtse foaowing: "I carlify that Ir the wormence of IN wvfk for wFaioh this portrait 11!exit), I aloe <br /> of O*'/any POPS00 in SoCh rnanrarr as to bet;.arne wt4em IQ wurkrmmn's cvsnpen•;.utiQn iww4 of CaUfoirra."Contractor's hiristg or st#conwac&V slWwttare <br /> owwiss tbv folowkV. ,I certify that in ti-4 pwfommnce of that work for which this perm*is issued,i shah emooy pomns sullf Art to ifs cofyg*nga. <br /> dw 41w0 of Lalif0lllii--" <br /> T�*appfwamtMW 600, Comgmete drawing on Nvem side <br /> Signed x- <br /> FOR DEPARTMENT USE ONLY <br /> Aptmkation Aoceptod by --- - -- Date <br /> PR Of&Ike° ils906Cb h fry Dote.�A Arta! 4neWtion by � <br /> Atklrtrortal GaRStrw►t;><: <br /> Appl •cEmt - Return &.11 cople7 t _ San Joaquin County Public Health 9eorvio** <br /> Environmot;al Hea:tb P*raitelearvicas ` <br /> 445 X sat. Jo,aquia, P O Box 2009, Sekn, CA WS20iTi <br /> INFO .4AAS.)l1MT t)vE AMOVkT R61�it'!'EU CAS14 RttEIM eW DA1E PeAM1TNp. y <br /> (�' `- Y.. 16,10-Z-51. Pa 733 <br />
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