Laserfiche WebLink
T,�(�la� Sarto-1 � l oN Wb66ll LIOZ Z 'APA MIM paAI ;3;� <br /> WELLIPUMP PERMIT <br /> • SANJOAOUINCOUNTY ENVIRONMENTAL HEOL-MDEPARTMFHT 1868EAsTHazELTatt AVENUE-$TocrloNCAnZ05-1209)46SZ420 <br /> NON-P.EFUNOABLE PERMIT CALF.(209)953-7697 FOR INSPECTIONS EXPIRES'I YEAR FRom DATE ISSUED <br /> JOB ADDRESS 16672 E St Rt 4 H 7 (na+-h) cmlDP Stockton , Ca. 95215 <br /> a <br /> CROSS SnRffT H n 1 1 a n h P r k APNPARCEL SIZEJ-100 LAND USE APPLICATION# ° <br /> OWNER NMT=_ Celli Brothers LLC PRONE_209-993-81 56 W <br /> MvNER ADOAEss 6161. Cherokee R d .//U0- A1A-$0M(-t_FT,s ATEIZJP S_t o c k t o n. CA 95212 <br /> T <br /> CONTRACTOR Purviance IJriInc. PHONE 209-8877-3554 <br /> CONTRACTOR ADDRESS P. 0. T3ox 64 CITYISTATSZIP Linden, Ck 9523 <br /> SUBCONTRACTOR PHONE <br /> I SUBCONTRACTOR AODRms CITYISTATEMP <br /> L;cEuse X C-57 _-C-61 I D-09 _011ier NUMBER 377923 E1w1RATIDN DATE 7/31 /17 <br /> GEOGRAPHICAL INFORMATION: Coordinates Y Township_ Range Section_ <br /> INTENDED USE DomesliJPdva'te 1lklni9atioNAgrEcul!ural Industrial _Water Quality Monitoring Soil SamplmgiCharaderizaL'Dn <br /> 1 PuNicYfaterSystem <br /> 7CIP.ercn:bpm ON.xr: e. m _ a me or one �•moer <br /> -rraEOF'AFORc _New Weil _ Replacement Weil :-;WeltAlterafforifMoffn-raton J Other <br /> MonitacingWeO(s) �oFvralls r;So)18odng(s) 00�bcrinps '--Geotechnical =orLorirgs <br /> Out-OfService Well 7 Out-Of-Service Well Renerral -1 Crass-ConneClian Repair <br /> !NewPumD 11 PLMP Re !acemenl Pump Re eir Raise Well Casing <br /> WELL CONSTRUCTION <br /> Drilling Method _Mud Rctary _Air Rosary ..Auga- _ Cable Tod _Push Point _ Other <br /> Proposed Well Depth 1 Excavation in diameler Oper(Bollom =Gravel PaWGravel Size in diameter <br /> I -CmldworCasirg In diameter i Conductor Casing Depth 1 f, <br /> Well Casting Diameter_in Thickness'GauaeJAST:N Schad <br /> Steel Plastic C StainlessSteel Other <br /> Grout Seal <br /> Dep fl Neat Cement(94/b be10 gat Lveter; _Sand Cement sack rnixf7golrrler : <br /> -9enlanite(209:solids) ;:Other SS <br /> GraLt Pisceiment Method ;Pumped £:Free Fall =other -Retardant 0 Accelerator(name) <br /> PEDESTAI. Installed By Driller -Pump Cant2clor Other <br /> _Concrete Pedestal=-Dimenslons:Width R Lenglh ft Thick in •ChristyHox i Stove Pip <br /> PUMP SubmersibleMTurbine Other HP� PumpSel R StandngWaterI—, II <br /> HEREBY CERTIFY THAT 1 HAVE PREPARED THIS APPLICATION AND THAT THE WORK WILL BE DONE IN ACCORDANCE WITH SAN <br /> JOAQUIN COUNTY ORDINANCES, STATE LAWS, AND RULES AND REGULATIONS. 1 ALSO CERTIFY THAT MY REQUIRED LICENSE IS <br /> CURRENT AND ACTIVE N1ITH THE CALIFORNIA CONTRACTORS STATE LICENSE BOARD AND THAT I AM IN COMPLIANCE WITH ALL <br /> WORKER NSATION <br /> F ININI 11 4H V . CE NOTICE REQUIRED FOR INSPECTIONS-PLEASE CALL(209)953-7697 i <br /> sIGNFo TrrL6 Corporate S ecretq,;;y 5/2/17 <br /> a <br /> I <br /> fT, <br /> I 10% I i z <br /> i <br /> mp <br /> � INO ; <br /> Z <br /> M? <br /> l I f I �� ti M <br /> I I <br /> PAYtiT`'i. i I <br /> REGE�V E I I l <br /> { it <br /> ARTMENT 5 ONLY <br /> IOAOUIN OtrpFWplicalion Accepted By Date <br /> 1RONME Area _ Employee IDT' <br /> H DEOARTIA' Grout lneDectlor:3y Dake ^^�� JD SPECIAL Welf Perunit <br /> Pump Inspection By e D/t 13.0 WAIVER Received <br /> Scil Boring Ins jmffon 8y Date Constructed Weil pp/gg���th It <br /> COMMENTS i-t fie.n b�L YV ar[c� �G./� s-9 —. 7+ r�DY>h �e !1/�T <br /> �% Ems`^• <br /> PESC Received CheckW Amount Oate PermitInvoice T Nell Il7p <br /> Codes Info 8 sh RemiKed So_;re Re uestX <br /> 15-1-310 CC 773 4GU FOOM3301 <br /> I <br /> :YeLL IPUt:?PeR;.117 <br /> Z•d bL9£L8960Z oul sl9llu4 eouelAund d I,Z:90 ZO OC AON <br />