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SAN J UIN COUNTY PUBLIC HEALTH S ICES . IRONMENTAL HEALTH DIVISIOW 445 N SAN JOAQUIN, PHONE (209)468-3420 One new monitoring P 0 BOX 2009, STOCKTON, CA 95201 well into B-zone, PERMIT EXPIRES 1 YEAR FROM DATE ISSUED approx 45 foot deep. (Complete in Triplicate) Application is hereby made to San Joaquin County for a permit to construct and/or install the work herein described. This application is made in compliance with San Joaquin County Ordinance No. 549 and 1862 and the Rules and Regulations of San Joaquin County Public Health Services. Job Address 2947 Navy Drive City Stockton Lot Site/Acreage Approx. 4 acres 888 S. Figueroa St Owner's Name Santare Pacific Pipeline Address Los Angeles, CA 90017 Phone 2825 E. Myrtle St. Contractor Spectrum Exploration Address Stockton, CA License no. _512,2,6-8—Phone TYPE OF WELL/PUMP: NEW WELL CA WELL REPLACEMENT ❑ DESTRUCTION ❑ Out of Service Well ❑ PUMP INSTALLATION ❑ SYSTEM REPAIR ❑ OTHER ❑ Monitoring Well DISTANCE TO NEAREST: SEPTIC TANK n/a SEWER LINES n/a DISPOSAL FLO. n/a PROP. LINE 40 r FOUNDATION n/a AGRICULTURE WELL -a-/—a OTHER WELL #_10' PITS/SUMPS ,T/n/a INTENDED USE TYPE OF WELL PROBLEM AREA CONSTRUCTION SPECIFICATIONS I/ 1.11 // CI Industrial ❑ Open Bottom ❑ Manteca Dia. of Well Excavation max �� Dia. of Well Casing w Cl Domutic/Private ❑ Gravel Pack ❑ Tracy Type of Casing PVC sch 40 Specifications 0.07" Slots I'I Public n Other 11 Delta Depth of Grout Seal 25 - 30 r Type of Grout cement grow I I Inigadon _Approx. Depth I I Eastern Surface Soul Installed by Spectrum Exploration _ Repair Work Done ❑ Type of Pump H.P. State Work Done _ Well Destruction ❑ Well Diameter Sealing Material i Depth Depth Filler Material a Depth TYPE OF SEPTIC WORK: NEW INSTALLATION I 1 REPAIR/ADDITION I I DESTRUCTION I I Me septic system permitted it public sewer is available within 200 feet.) Installation will serve: Residence_ Commercial_ Other Number of living units: _ Number of bedrooms Character of sail to a depth of 3 feet: Water table depth SEPTIC TANK ❑ Type/Mfg Capacity No. Compartments PKG. TREATMENT PLT. ❑ Method of Disposal Distance to nearest: Well Foundation Property Line ,1mC'E``aez LEACHING LINE L1 No. b Length of lines Total length/size RE FILTER BED ❑ Distance to nearest: Well Foundation Property Linunn_t rq 1D9'� SEEPAGE PITS I I Depth Size Number SAN J �UIL, rIrALl "`� I � ICES SUMPS LI Distance to nearest: Well Foundation Prop mpjTA{-HEALTH DIVISION DISPOSAL PONDS ❑ I hereby certify that I have prepared this application and that the work will be done in accordance with San Joaquin county ordinances, state laws, and rules and regulations of the San Joaquin County Home owner or licensed agent's signature certifies the following: "I certify that in the performance of the work for which this permit is issued, I shall not employ any person in such manner as to become subject to workman's compensation laws of California." Contractor's hiring or subcontracting signature certifies the follow�W. I certify that in the performance of the work for which this permit is issued, I shall employ persona subject to workman's compensa- tion lawn of Calitor (e." The applicant s Complete drawing on reverse side. Signed Tide: PRDIECT E0103IS1 Date: March 9, 1993 FOR DEPARTMENT USE ONLY �! c Application Accepted by - Date "t `-J 7-3 Area 30 Pit or Grout Inspection by 7" ' Date Final Inspection by Date Additional Comments: Applicant - Return all copies to; San Joaquin County Public Health Services Environmental Health Permit/Services 445 N San Joaquin, P O Box 2009, Stkn, CA 95201 FEE AMOUNT DUE KS AMOUNT REMITTED CASH RECEIVED BY DATE PERMIT NO. INFO Q � (�z . EN IY2E(REV.'/A 51 ' h L� I l l V EH 14-20 V //