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oPnuiN.,c SAN JOAQUIN COUNTY )... � ..0 Q. ENVIRONMENTAL HEALTH DEPARTMENT 1868 East Hazelton Avenue, Stockton, CA 95205-6232 oP Office:(209) 468-3420 Fax:(209) 464-0138 Web:wvvw.sjgov.org/ehd q�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: �n� DATE:;�' PROPERTY OWNER NAME: 1 it V RECORD ID#: Co o c6 L f31 T TYPE OF INSPECTION: ❑COMPLAINT STATUS CHECK ❑OTHER 't NATURE OF COMPLAINTNIOLATION: ()1W 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 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 Backf low 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. ❑ Cover well with a watertight,secure well cover. ;�,Obtain permit as indicated: ,K Destruction ❑Construction JKPump ❑Well Repair/Cross Connection,n Out of Service Well COMPLIANCE DATE:9 IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS ❑ 14 DAYS ❑ COMMENTS: �1 ao v wi COST RECOVERY:All EHD staff time associated with resolving this complaint will be billed at the current hourly rate( s U,\+,` FAILURE TO COMPLY: Failure to Comply with this Notice May Result in Formal Enforcement Action. '-+ -W , -� 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 �300ddays of receipt of this notice. INSPECTED BY: A�{. c�Cl�l��' mil/, PHONE: 2" 1 -l:I —� I CCFFFC�� C� SIGNATURE OF REGIS-T�E-R�EED ENVIRONME,NTTAALL HEALTH SPECIALIST � A RECEIVED BY: AL11 ' " 0�'y r DATE: SIGNATURE OF OWNER/TENANT EHD 43-12 1017/13 WATER WELL NOTICE TO ABATE