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V V <br /> 5 <br /> I bU 1 L+►A !lr/�lluo A rs�y,.t <br /> Mom 46"781 AREA 06 <br /> STOCKTON. CALIFORNIA . <br /> INSPECTION REPORT <br /> Owmf/Opcsalor r r C l ire Lr <br /> .Address 2-2- -7(--) ,J. u 144n City STcCC (Tr- - - <br /> Water Purveyor Code <br /> 'Ilt.�fGlIcmias oonvctiom are to be m.ee:. <br /> I Ddetroy the ahandoned well tinder permit ,ani <br /> . inspection of the San Joaquin Local Heal <br /> District by _ <br /> Date <br /> ❑Seal the well under permit and inspection of <br /> the San Joaquin Local Health District b <br /> Date <br /> if you are currently connected to a public _ <br /> water supply you are required to provide. an <br /> aggroved ba k low prevention device to_ prat.ect <br /> the public water supply or destroy the e&Laj jjg <br /> Well . <br /> A referral will be made to the public water <br /> supplier for thQIr enforcement of backflow _ <br /> prevention requirements . <br /> Contact your water su22lier and local Building- <br /> De.partmpnt for eci f an --.._pPr1T1i tS�and <br /> required monitoring reguirements , <br /> fkco«nKa Naiac <br /> )(HA Al1A\XA, NI.D.. SUM. I)iseti- llrald, 011i,rr <br /> 1 RrRlrred �.uiirlan <br /> E 00 20 7 ,05 <br />