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SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES ENVIRONMENTAL HEALTH DIVISION 445 N SAN JOAQUIN, PHONE (209)468-3420 one new monitoring P O BOX 2009, STOCKTON, CA 95201 well into B-zone, approx 45 foot deep. PERMIT EgPIRES 1 'YEAR FROM DATE ISSUED (Complete in Triplicate) Application is hereby made to San Joaquin County for a permit to construct and/or install the work herein described. This i application is made in compliance with San Joaquin County Ordinance No. 549 and 1862 and the Rules and Regulations of San Joaquin County Public Health Services. P Job Address 2947'Navy DriveCity t. Stockton Lot Size/Acreage A rox. 4 acres - t _ . _ 888 S. Figueroa St 213 486,7947 Owner's Name Santare Pacific Pi line Address Los An eles Phone 2825 E. Myrtle St. w Contractor Spectrum -EXploratl.On Address Stockton CA License No. 5122618 Phone -465-871 209 TYPE OF WELL/PUMP: NEW WELL C7 WELL REPLACEMENT DESTRUCTION .� Out of Service Well ❑ SYSTEM REPAIR EG OTHER G Monitoring Well PUMP INSTALLATION ❑ , DISTANCE TO NEAREST: SEPTIC TANK i n/a SEWER LINES n/a DISPOSAL FLD. n/a PROP. LINE 40 f n/a r FOUNDATION AGRICULTURE WELL 11/a OTHER WELL `k 1Q PITS/SUMPS -nLa INTENDED USE PROBLEM AREA CONSTRUCTION SPECIFICATIONS 1! l� TYPE OF WELL rr // n Industrial ❑ Open Bottom ❑ Manteca Dia. of Well Excavation X, 111(0 Dia. Iof Well Casing ru n Domestic/Private 0 Gravel Pack C7 Tracy Type of Casing PVC SCh 40 Specifications 1 i Public Cl Other f l Delta Depth of Grout Seal 25 — 30 r Type of Grout Cement groUl A rax. Depth I ] Eastern Surface Said Installed by_ Spectrum r�loration I I Irrigation PP Repair Work Done 0 Type of Pump H.P. State Work Done , Well Destruction ❑ Well Diameter, Sealing Material & Depth Depth FI Filler Material & Depth TYPE OF SEPTIC WORK: NEW INSTALLATION I 1 REPAIRJADDITION ( I DESTRUCTION I I INo septic system permitted if public sewer is available within 2013 feet.) Installation will serve: Residence_— Commercial— Other .� Number of living units: Number of bedrooms Character of soil to a depth of 3 feet: `I Water table depth SEPTIC TANK ❑ Type/Mfg ) Capacity No. Compartments PKG. TREATMENT PLT. ❑ Method of Disposal Distance to nearest: Weil Foundation Properly Line ANT LEACHING LINE ❑ No. & Length of lines Total length/size- RECEIVED FILTER BED ❑ Distance to nearest: Well Foundation Property UnMn-1793 JCD SA SEEPAGE PITS I I Depth )-i Size Number N {CES SUMPS Lt Distance to nearest: Well Foundation Pr � STH DIVISION DISPOSAL POSAL PONDS ❑ ' I hereby certify that I have prepared this.application and that the work will be done in accordance with San Joaquin county ordinances, state laws, and rules and regulations of the San Joaquin County wing: "I certify that in Home owner or licensed agent's signature certifies the folio the performance the work for which this permit is issued, I shall not tion laws of California." Contractor's hiring or sub contracting signature employ any person in such manner as to become subject to workman's compensa cartifie:tfie followi . 'I certify that in the performance of the work for which this permit is issued,I shall employ persons subject to workman's compansa- tion laws of Califor a." ! h The applicant s or )red inspections. Complete drawing on reverse side. Signed Title: EEQ= Q=QGTST Data; March 9 1993 FOR DEPARTMENT USE ONLY !� Application Accepted by Date Area 30 I Pit or Grout Inspection by /" Date T� -- Final Inspection by Data Additional Comments: Applicant - Return all copies to: San Joaquin County Public Health Services Environmental Health Permit/Services 445 N San Joaquin, P O Bax 2009, Stkn, CA 95201 CK FEE AMOUNT DUE AMOUNT REMITTED CASH RECEIVED BY DATE PERMIT'NO. INFO JQ�QJ EH 13.24 tREV.Iy14s) f f LJ r� `7-5 EH 14.26 II �