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p41�" SAN JOAQUIN COUNTY r. ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 c.,__ _ �P Office:(209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd F2iR� WATER WELL NOTICE TO ABATE San Joaquin County Ordinance Code, Title 9 LOCATION: / / n CITY: f, DATE: `/ PROPERTY OWNER NAME: RECORD ID#: TYPE OF INSPECTION: IkCOMPLAINT ❑STATUS CHECK ❑OTHER NATURE OF COMPLAINTNIOLATION: eil j hfu i' d '4e"-kL t1&L /-Anv-C Val Aa h7f, VIOLATIONS: It shall be unlawful to maintain or use any residence or place of business which is not in compliance with the 1• ❑ requirements of SJC Ordinance Code,Title 9, Chapter 9-1115 or the SJC Water Well Standards. SJC Ord.Code,Title 9, Section 9-1115.9. Abandoned Well - not in use; no power source to well; open and unsecured; approved out-of-service well not being 2. ❑ maintained; in a state of disrepair; or well casing buried. CA Health&Safety code,Section 115700(a)(b)(d);CA Health&Safety Code,Section 115710;SJC Ord.Code,Title 9,Section 9-1115.5-Well Regulations,SJC Water Well Standards,Section 6.1. Approved Out-of-Service Well not being Maintained Properly-well has defects;well acting as conduit for 3. ❑ contamination of groundwater;well is not properly sealed; well is not marked; well is not kept clear of brush or debris. CA Health&Safety Code,Section 11 5700 d ;SJC Water Well Standards,Section 5.1.-Out of Service Wells. 4. ❑ Provision of Water from Separate Parcel, Use of a Well Pit. SJC Ord.Code,Title 9,Section 9-1115.8-Prohibited Uses 5. Lack of or Inadequate Sanitary Seal at Wellhead. SJC Ord.Code,Title 9,Section 9-1115.5-Well Regulations 6. ❑ Lack of or Inadequate Surface Seal around Well Casing.SJC Water Well Standards,Section 4.10. -Surface Seal 7. ❑ Sounding Tube or Air Vent not Sealed. SJC Water Well Standards,Section 4.12.-Sounding Tube/Air Vent Pipe 8. Lack of or Inadequate Sampling Tap. SJC Water Well Standards,Section 4.13.-Sampling Tap 9. Lack of or Inadequate Backflow Prevention. SJC Water Well Standards,Section 4.14.-Backflow Prevention 10. ❑ Work being Conducted without a Permit-construction; destruction; pump; repair; sanitary seal broken; or cross- connection repair. SJC Ord.Code,Title 9,Section 9-1115.3-Well Permit Required CORRECTIVE ACTIONS/ORDERS: Effective Immediately: ❑ Cease work and obtain an approved permit as indicated below ❑ Cover well with a watertight, secure well cover N Obtain permit as indicated: ❑ Destruction ❑ Construction ❑ Pump 'Well Repair/Cross Connection ❑ Out of Service Well (Out of Service wells must meet certain requirements-Contact the Environmental Health Department for details) COMPLIANCE DATE: ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS k 14 DAYS ❑ COMMENTS: O 6 u w ALL EHD STAFF TIME ASSOCIATED WITH RESOLVING THIS COMPLAINT WILL BE BILLED AT THE CURRENT HOURLY RATE($125) FAILURE TO COMPLY WITH THIS NOTICE MAY RESULT IN FORMAL ENFORCEMENT ACTION INSPECTED BY: /rLc PHONE: ~daky� —�� —�� SIG ATURE OF REGISTERED ENVIRONMENTAL HEALTH SPECIALIST RECEIVED BY: /n4j ` 7_',;V DATE: SIGNATURE OF OWNER/TENANT EHD 43-12 2/5/13 WATER WELL NOTICE TO ABATE