SU0015028 - Laserfiche WebLink

Home Browse Search

SANJ O A Q U I N Environmental Health Department COI, N T Y EXISTING WELLS INFORMATION Total Number Existing Wells on Property]3 Please complete the information below for every well on property. Use extra paper if needed. Well##1 Information Landfill Entrance Use of Well: ❑ Domestic 1!1 Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock IN Other:on-site industrial use for landfill facility Total Depth(ft): 135-ft To: From: Casing Diameter(in): Screen Interval(ft): To: From: Pumping Rate m : 1500 To: From: Annual Extraction Volume(acre-feet: ❑ Estimated ❑ Measured Specific Capacity al/min/ft Other Pumping Tests Performed:1 Test Result: Well##2 Information SE Corner of Resource Recovery Facility Use of Well: ❑ Domestic 19 Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock N Other:on-site industrial use for landfill facility Total Depth(ft): To: From: Casing Diameter(in): Screen Interval(ft): To: From: Pumping Rate m : eoo To: From: Annual Extraction Volume(acre-feet: ❑ Estimated ❑ Measured Specific Capacity (gal/min/ft):, Other Pumping Tests Performed:1 Test Result: Well#3 Information NW Corner of Former Austin Road Landfill Use of Well: ❑ Domestic 19 Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock ❑ Other:on-site industrial use for landfill facility Total Depth(ft): To: From: Casing Diameter(in): Screen Interval(ft): To: From: Pumping Rate pm : so To: From: Annual Extraction Volume(acre-feet: ❑ Estimated ❑ Measured Specific Capacity al/min/ft Other Pumping Tests Performed:1 Test Result: MAP INFORMATION A project site map must be attached to this form and shall include the following information: • Legal lot and parcel dimensions. • All well locations on legal lot and parcel with type and use information shown for each well. • All onsite sewage treatments stems,stormwater ponds, process water ponds,and other sources of potential contamination. • Distance from proposed well to any potential sources of pollution onsite and on adjacent properties, including: o Existing or proposed onsite sewage treatments stems,wells,animal or fowl enclosures,transmission lines, sewer lines. o Distance from ponds, lakes, rivers and streams within 300 feet and navigable water was within one mile. o For wells below Corcoran clay, map must show location of canals,ditches, pipelines, utility corridors, and roads within two miles. 2of2