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Ruvalcaba, Cesar [EHD] <br /> From: Sierra Bacigalupi <sierra.masellisdrilling@gmail.com> <br /> Sent: Friday, October 7, 2022 12:47 PM <br /> To: EH Welland SepticPermits [EHD] <br /> Subject: Re: E Tobacco Rd Linden APN 10514032 <br /> Attachments: Image_00232.pdf <br /> This is not a Facility, it is just a farm shop with a single residence in the front. <br /> Attached is the form you requested. Please let me know if you have any questions. <br /> Thanks <br /> Sierra <br /> Masellis Drilling Inc <br /> 209-522-1928 <br /> On Wed, Sep 28, 2022 at 9:00 AM EH WellandSepticPermits [EHD] <ehwellandsepticpermits@slgov.org>wrote: <br /> Hi Sierra, <br /> We will need the facility to fill out the following form and submit it for review before we can permit the well. <br /> https://www.s*gov.org/docs/default-source/environmental-health-documents/small-public-water-systems- <br /> (spws)/water-provision-declaration.pdf?sfvrsn=a3aca093 3 <br /> Also the submitted well exemption statement indicates that this will be a new well, meaning there aren't any other <br /> wells that serve the same purpose on the property. Per the site map there is another similar well.The Well Exemption <br /> Statement form option would be a replacement well with the same extraction as the existing well that it is replacing <br /> and the fate of the existing well would need to be documented as either serving the existing residence (or business) or <br /> irrigating residential landscape, otherwise the well should be destroyed. <br /> Submit the Water Provision Declaration and the Well Exemption Form with the most accurate information. <br /> Thank you, <br /> Cesar Ruvalcaba <br /> San Joaquin County Environmental Health Department <br /> 1 <br />