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PauiN�O. •.0. SAN JOAQUIN COUNTY � OG N; {I ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 CqC/FOtl�\P Office:(209) 468-3420 Fax: (209) 464-0138 Web:www.sjgov.org/ehd WATER WELL NOTICE TO ABATE San Joaquin County Ordinance Code, Title 9 and Title 8,Section 5-5100: It is a violation for any propertyowner to maintain a nuisance in his property, LOCATION: r-- CITY: DATE: PROPERTY OWNER NAME: . n t r (� �� N v n RE CO R6 ID#: TYPE OF INSPECTION: ❑COMPLAINT &TATUS CHECK ❑OTHER (sue NATURE OF COMPLAINT/VIOLATION: tk-) 1 in dr3r6P,4;r VIOLATIONS: It shall be unlawful to maintain or use any residence or place of business which is not in compliance with the 1• K 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—Compliance Required. 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. not being Maintained Properly-well has defects;well acting as conduit for 3. conta_urination 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. `d 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. X 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: ❑ Cease work and obtain an approved permit as indicated below. 2j Cover well with a watertight, secure well cover. X Obtain permit as indicated: A Destruction ❑Construction Pump ❑Well Repair/Cross Connection kK Out of Service Well COMPLIANCE DATE: ❑ IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS❑ 7 DAYS ❑ 14 DAYS ® Ct 5• c COMMENTS: 'A ; i M v COS RECO Rv- All EHD stIi time associated with resolving this complaint will be billed at the current hourly rate(PAW7 FAILURE TO COMPLY: Failure to Comply with this Notice May Result in Formal Enforcement Action. 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 filing a written request with the San Joaquin County Environmental Health Department /within �30 days/of receipt off this notice. INSPECTED BY: PHONE: `�✓ 4�6 1 t SIGN0JRE OF REGISTERED E/ °''ENVIRONMENTAL HEALTH SPECIALIST RECEIVED BY: M.G�,I I ' `-' r�� DATE: SIGNATURE OF OWNER/TENANT EHD 43-12 1017/13 WATER WELL NOTICE TO ABATE