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Clements CSA New Well i r° Page 1 of 2 <br /> Lisa Medina EH <br /> From: Adrienne Ellsaesser[EH] <br /> Sent: Thursday, October 20, 2005 8:29 AM <br /> To: Lisa Medina [EH] <br /> Subject: FW: Clements CSA New Well <br /> -----Original Message----- <br /> From: Ron Rall [mailto:rrall@sjgov.org] <br /> Sent: Wednesday, October 19, 2005 3:03 PM <br /> To: Adrienne Ellsaesser [EH] <br /> Cc: Ben Guzman <br /> Subject: RE: Clements CSA New Wel <br /> I am completing the permit app. for Clements. What Health Dept address do we use? (indicated in red on the <br /> permit app) Ben said he has supplied you with the Subdivision maps which should give you most of the info you <br /> asked for. Didn't the developer already do a SWAP to drill the well? <br /> -----Original Message----- <br /> From: Adrienne Ellsaesser [EH] [mailto:AEllsaesser@sjcehd.com] <br /> Sent: Wednesday, October 05, 2005 4:02 PM <br /> To: Ron Rall <br /> Subject: Clements CSA New Well <br /> i <br /> <<A SPWS Permit Amendment Appl..doc>> <br /> Ron, <br /> Here is the Permit Amendment form. Please complete it noting what additions will be <br /> made to the existing CSA system (i.e.- new well, new distribution lines, new pressure <br /> tank, etc.) Submit the completed form along with the $279 amendment fee and new <br /> distribution map to EHD. The map needs to show the location of all proposed and <br /> existing: <br /> - domestic and fire distribution lines. Location where the new distribution line(s) <br /> connects into the existing CSA system. <br /> - septic systems and septic expansion areas <br /> - retention ponds <br /> - any potential source that may contaminate the well (under ground/above ground <br /> tanks, etc) located with in 150' of the new well. <br /> r <br /> - parcels and structures that will be connected to this system. <br /> Thank you, i <br /> I <br /> Adrienne Ellsaesser <br /> Lead 5r. REHS � <br /> Small Public Water Systems <br /> 10/20/2005 <br />