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p411N SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTH DEPARTMENT <br />1y,1 <br />1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br />Office: (209) 468-3420 Fax: (209) 464-0138 Web: www.sjgov. <br />q�IF.ORt'� <br />WATER WELL NOTICE TO ABATE <br />San Joaquin County Ordinance Code, Title 9 and Title 8, Section 5-5100: <br />It is a violation for any property owner to maintain a nuisance in his property. <br />LOCATION: CITY: DATE: <br />PROPERTY OWNER NAME: RECORD ID#: <br />TYPE OF INSPECTION: QCOMPLAINT ❑STATUS CHECK ❑OTHER <br />NATURE OF COMPLAINTNiOLATION: <br />VIOLATIONS: <br />It shall be unlawful to maintain or use any residence or place of business which is not in compliance with the <br />1 • ❑ requirements of SJC Ordinance Code, Title 9, Chapter 9-1115, or the SJC Water Well Standards. SJC Ord. Code, Title <br />9, Section 9-1115.9 — Compliance Required. <br />Abandoned Well - not in use; no power source to well; open and unsecured; approved out -of -service well not being <br />2. ❑ maintained; in a state of disrepair; or well casing buried. CA Health & safety code, Section 115700(a)(b)(d); CA Health & Safety <br />Code, Section 115710; SJC Ord. Code, Title 9, Section 9-1115.5 — Well Regulations, SJC Water Well Standards, Section 6.1. <br />Approved Out -of -Service Well not being Maintained Properly - well has defects; well acting as conduit for <br />3. ❑ contamination of groundwater; well is not properly sealed; well is not marked; well is not kept clear of brush or debris. CA <br />Health & Safety Code, Section 115700(d); SJC Water Well Standards, Section 5.1. — Out of Service Wells. <br />4. ❑ Provision of Water from Separate Parcel, Use of a Well Pit. SJC Ord. Code, Title 9, Section 9-1115.8 — Prohibited Uses <br />5. ❑ Lack of or Inadequate Sanitary Seal at Wellhead. SJC Ord. Code, Title 9, Section 9-1115.5 — Well Regulations <br />6. ❑ Lack of or Inadequate Surface Seal around Well Casing. SJC Water Well Standards, Section 4.10. — Surface Seal <br />7. ❑ Sounding Tube or Air Vent not Sealed. SJC water well standards, Section 4.12. — Sounding Tube/Air Vent Pipe <br />8. ❑ Lack of or Inadequate Sampling Tap. SJC Water Well Standards, Section 4.13. — Sampling Tap <br />9. ❑ Lack of or Inadequate Backflow Prevention. Sic Water well Standards, Section 4.14. — Backflow Prevention <br />io ❑ Work being Conducted without a Permit - construction; destruction; pump; repair; sanitary seal broken; or cross - <br />connection repair. SJC Ord. Code, Title 9, Section 9-1115.3— Well Permit Required <br />CORRECTIVE ACTIONS/ORDERS: <br />❑ Cease work and obtain an approved permit as indicated below. ❑ Cover well with a watertight, secure well cover. <br />❑ Obtain permit as indicated: ❑ Destruction ❑ Construction ❑ Pump ❑ Well Repair/Cross Connection ❑ Out of Service Well <br />COMPLIANCE DATE: ❑ IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS ❑ 14 DAYS ❑ <br />COMMENTS: <br />COST RECOVERY: All EHD staff time associated with resolving this complaint will be billed at the current hourly rate ($139). <br />FAILURE TO COMPLY: Failure to Comply with this Notice May Result in Formal Enforcement Action. <br />APPEAL PROCESS: Any owner or person in possession who objects to the finding of violations cited on this notice may request an office hearing by <br />filing a written request with the San Joaquin County Environmental Health Department within 30 days of receipt of this notice. <br />INSPECTED BY: <br />PHONE: <br />SIGNATURE OF REGISTERED ENVIRONMENTAL HEALTH SPECIALIST <br />RECEIVED BY: DATE: <br />SIGNATURE OF OWNER/TENANT <br />EHD 43-12 8/1/16 WATER WELL NOTICE TO ABATE <br />