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Site Address: 18437 Collier Rd, Acampo CA 95220 Record ID: WP0042692 <br /> Date: 11/3/2021 <br /> PHOTO # 1 New Well. Well Log. Grouted from 100 ft using 10.3 sand cement. <br /> LL/PUMP PERMIT 2 3 �� S�H� <br /> /IRONMENTAL HEALTH UEn , 1868 EAST 1"IAZELTON AVENUE-STOCKTON CA 96206-6272 (206)468-7420 -7 ` r ,G2 <br /> SRMIT MSOV-Org/Bhd EXPIRES 1 VEAR_FROM GATE ISSUER <br /> 1�1r/'� l clTV/z.lr . / 3 - 6 S— G G- X <br /> 0 2 1 �L/ Z PARCEL IS,—���NO U6E <br /> PHPNE <br /> /� C(TYI6TATI,��i• ZS"- c).�_ � 2"a — ��=�� <br /> / <br /> N <br /> ILTANT AOPRE68 CITYIST �.21v - /1 <br /> o C-61 o o-os) O Other NVMBER 3 7 ExPIRATION RATE �-3 Z O S,_ 7� �^�[�Ci,}(/ J <br /> o OWNER .1>60NTRACTOR o SUBCON T RACTOR/CONSUI.�n NT _ /.741, <br /> uwo: General Mineral/Coliform Bacteria(439'1)O Olbromochloro ,pane(4392)C]Arsenic(4393) <br /> O o <br /> m lin /CharaclanT-- 2... j_ -3 /r <br /> T,ealldPriV-ta O Irrlgallon/Agricultural O Indualrlal O Water Oua11fY M-, oring Soll Sa p g G <br /> arl...l:'"«a.n ow...r m _-_ d.,.d N.n,•o,P.,ca.N...w.r 2-S'-- .5.�N�- 6r� � <br /> MI Wa6 o Raplacom enl Well o Wall AllaraVONNlodlBcallon •nl boAnpe er O C3aotachnlcal •a bab•a� f <br /> ,nrtonng wau(.) n o(vuana o son Bonng(•) "3, -r ��� -G �Q`1 <br /> It-0(-Sarvlce Wall O Out-O(-service Wall Ranr>wal o Cross-Connaollon Repair <br /> ew PumP O P P R Ple t O Pump RePalr (:>Wall Gaoln �a <br /> ud Ro1ary O Air Rotbry O Aug o Cable Toot O Puah 1''olntI• Olhar- el PecWGraval Sizes In diameter <br /> (h Yds rt IF. mi— .12 In dlarnele-r o Opan Dotlotn $Gray <br /> :onduclor casing jr, n diameter / Conductor Casing oapth __._ 3 G� <br /> malar n ThleKhass/Gauge/ASTM Sc <br /> had Z�J O.Steellaallc [7 Stalniesa�5la7a1 o Olha a eH m/x/7'gal Westar J <br /> ,lh%JO a O Neal Cement(9416 6-9/5-10 9-/watch Sand Camanl /'1. ��� /-• y�l J <br /> 3anlonlla(20%aollda) O Other O / ,�,J,�G. ,` <br /> thod pumped- O free Fell o Other o Rala_rdant/ACGaleralor(Hama <br /> at-11•d By �✓Orlllar R Pump ContractorO Olhar i o Christy Box O Btova Plpa <br /> Concrota Podast 1yRlmonalon-:Wldlh f rl- l gti it TT Icic <br /> ubmaralbis0 Tu InaO Olhar HPr` S n Standing - <br /> 'Y THAT 1 MAVF PREP.AR EP THIS APPLICATIOL/ ANO THAT+THE —*K W" i1E HONE IN ACCORRALJ C.E WITFI SBt, �,' <br /> Y ORDINANCES, STATE LAW B, ANA RULE- ANO RE G(Jt ATI. N6_ 1 AtSO'GERTIrrY THAI .MY RE.OUIRLECJ'R_1GE:N SE IS I T/- An.--e'er—�`'"� -- '; "'- <br /> ,vE WITH TME CALIFORNIA G NU RAGTORS BT ATE LIC EN6E BOARD AND THAT 1 AM tN COMPLIANCE WITH ALL <br /> ENHAIION LAWS_ <br /> LN/1 HOU ADV ANC F_NOTICE REQUIRE-D FOR INSPECTIONS-PLEASE CALL(209)953-7697 <br /> Francisco Garcia Ruiz, Environmental Health Specialist Trainee Page 1 of 2 <br />