Laserfiche WebLink
PUMP HP ft Pump Set ft Standing Water Level 0 Submersible E Turbine 0 Other <br />WELL CONSTRUCTION <br />Drilling Method o Mud Rotary E Air Rotary it Auger 0 Cable Tool 0 Push Point 7 Other <br />Proposed Well Depth 30 ft Excavation 4 inches in diameter C Open Bottom LI Gravel Pack/Gravel Size in diameter <br /> <br />0 Conductor Casing in diameter / Conductor Casing Depth ft <br />Well Casing Diameter in Thickness/Gauge/ASTM Sched 0 Steel 0 Plastic 0 Stainless Steel E Other <br />Grout Seal Depth $.L.) ft 9; Neat Cement (94 lb bag/5-10 gal water) E Sand Cement sack mix/7 gal water <br />0 Bentonite (20% solids) E Other <br />Grout Placement Method 0 Pumped 0 Free Fall IN Other Tremie it in <br />0 Retardant! Accelerator (name) <br />PEDESTAL Installed By E Driller 0 Pump Contractor 0 Other <br />LI Concrete Pedestal :Dimensions Width ft Length ft Thick in LI Christy Box Stove Pipe SS3110CIV 311$ WELLJPUMP 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 />JOB ADDRESS <br /> 2706 Pock Lane oryizip Stockton/CA <br />CROSS STREET Eleventh St ApN 179-12-0135 179-12-014 907 Acres <br />PARCEL SIZE 9.67 Ames LAND USE APPLICATION # <br />OWNER NAME <br /> Anthony Barkett <br />PHONE <br />OWNER ADDRESS 119 East Weber Ave <br />CITY/STATE/ZIP Stockton/CA/95202 <br />CONTRACTOR <br /> West Coast Exploration Ince PHONE 209-985-7541 <br />CONTRACTOR ADDRESS P0 Box 133 <br /> <br />CITY/STATE/ZIP Escalon/CA/95320 <br />SUBCONTRACTOR/CONSULTANT CTE Cal Inc <br />PHONE 209-543-1799 <br />SUBCONTRACTOR/CONSULTANT ADDRESS 4230 Kiernan Ave Ste 150 <br />CITY/STATE/ZIP Modesto/CA/95356 <br />LICENSE N C-57 E C-61 0 D-09 0 Other NUMBER 870761 EXPIRATION DATE 1/31/2022 <br />BILLING PARTY: G OWNER 0 CONTRACTOR 01 SUBCONTRACTOR/CONSULTANT <br />DOMESTIC WELL SAMPLING: C General Mineral/Coliform Bacteria (4391) Dibromochloropropane (4392) 0 Arsenic (4393) <br />INTENDED USE El Domestic/Private 0 Irrigation/Agricultural 0 Industrial 0 Water Quality Monitoring N Soil Sampling/Characterization <br />E Public Water System <br />If different from Owner: Water System Name Contact Name or Phone Number <br />TYPE OF WORK E New Well LI Replacement Well 0 Well Alteration/Modification 0 Other <br />E Monitoring Well(s) # of wells 0 Soil Boring(s) 9 of borings Geotechnical 5 # of borings <br />0 Out-Of-Service Well 0 Out-Of-Service Well Renewal 0 Cross-Connection Repair <br />0 New Pump 0 Pump Replacement E Pump Repair 0 Raise Well Casing <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 /ea/Wald 0.5Y-aed.I.44, T TLE Staff Geologist DATE 2/12/2021 <br />SE <br /> <br />A <br /> <br />A <br />PAYMENT <br />REGEWFD <br />ra 1 3 2021 <br />SA , OAQUI CAA) NTY <br />E.NA/I ION MENTAL <br />ALTFi DEPARTMENT <br />DEPARTMENT USE ONLY <br />Application Accepted By ...---7/----2/ Date ,07 /4 ,..' Area i iq 9 Employee ID# <br />Grout Inspection By A . ,---%-----"."---"---------- Date II 0 SPECIAL Well Permit <br />Pump Inspection By Date 0 WAIVER Received <br />Soil Boring Inspection By Date Constructed Well Depth ft <br />COMMENTS <br />PE <br />Codes <br />SC <br />Info <br />Re eived Check#1 <br />Ca,s1 .i <br />count <br />milled Date Permit/ <br />Service Request # Invoice # Well ID# <br />7$ POO tf i ii 0 <br />EHD 43.06 6/11/2019 WELL /PUMP PERMIT