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A41'" SAN JOAQUIN COUNTY r. 2 ENVIRONMENTAL_ HEALTH DEPARTMENT Q 1868 East Hazelton Avenue, Stockton, CA 95205-6232 Office:(209) 468-3420 Fax:(209) 464-0138 Web:www.sjgov.org/ehd C4G%F pRN�P 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: I DATE: PROPERTY OWNER NAME: RECORD ID#: TYPE OF INSPECTION: IPOMPLAINT ❑STATUS CHECK ❑OTHER NATURE OF COMPLAINTNIOLATION:��S�� 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. K 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 115700(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 Backflow 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: KDestruction ❑Construction ❑ Pump ❑Well Repair/Cross Connection ❑ Out of Service Well COMPLIANCE DATE: ❑ IMMEDIATELY ❑ 24 HOURS ❑ 48 HOURS ❑ 7 DAYS 14 DAYS ❑ COMMENTS: ,4- r v r Z c P4�{ /l Cty j. Y` i .r C,nr1 ��z tri�lif `)/ e' COST RECOVERY:All EHD staff time associated with resolving this complaint will be billed at the current hourly rate($139). FAILURE TO COMPLY: Failure to Comply with this Notice May Result in Formal Enforcement Action. 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,q written request with the San Joaquin County Environmental Health Department withhiijn'30 jdays ofreceiptof this notice. INSPECTED BY: G `�. PHONE: ,�Cj I ATURr✓ REGIST ENVIRONMENTAL EA HSPECIALIST 120 c III / �^ RECEIVED BY: 51*tDATE: SIGNATURE OF OWNER/TEN CA '76 b.9 r EHD 43-12 8/1/16 WATER WELL NOTICE TO ABATE