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oP.a U., c SAN JOAQUIN COUNTY 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 �"q C IFOR? 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: �- ,/ CITY:J . DATE: PROPERTY OWNER NAME: RECORD ID#: n - TYPE OF INSPECTION: ❑COMPLAINT STATUS CHECK ❑OTHER NATURE OF COMPLAINT/VIOLATION: 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-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. 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 115700 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 Backf low Prevention. SJC Water Well Standards,Section 4.14.-Backflow Prevention 10 El connection 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. ❑ Cover well with a watertight, secure well cover. ❑ Obtain permit as indicated: ❑ Destruction ❑ Construction aPump ❑Well Repair/Cross Connection ❑ Out of Service Well COMPLIANCE DATE: IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS ❑ 14 DAYS ❑ COMMENTS: [ ,Jl1Yl -) J .r lvAI air v 14 t et i(,q ar -Yale�4. So no COST RECOVERY: All EHD staff time associated with resolving this complaint will be billed at the current hourly rate(�125): 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 offide hearing by filing a written request with the San Joaquin County Environmental Health Department within 30 days of receipt of this notice. INSPECTED BY: PHONE: (`- O 1-6'6 - J 1✓j SIGNATURE OF REGISTERED ENVIRONMENTAL HEALTH SPECIALIST a/ 1-j j 53 100 k �t RECEIVED BY: ,, i DATE: SIGNATURE OF OWNER/TENANT EHD 43-12 1017/13 WATER WELL NOTICE TO ABATE