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WP0037793
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4200/4300 - Liquid Waste/Water Well Permits
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WP0037793
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Entry Properties
Last modified
9/29/2018 10:53:24 PM
Creation date
5/17/2018 11:40:07 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
WP0037793
PE
4369
STREET_NUMBER
26192
Direction
N
STREET_NAME
MACKVILLE
STREET_TYPE
RD
City
CLEMENTS
Zip
95227-
APN
02116042
ENTERED_DATE
1/11/2018 12:00:00 AM
SITE_LOCATION
26192 N MACKVILLE RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
DAfonskaia
Supplemental fields
CYEAR
2018
Tags
EHD - Public
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r •-y <br /> f .� � SAN Environmental Health Department <br /> w < --C O U N T Y <br /> Greatness grows here. <br /> New Well Information <br /> Pursuant to California Water Code, Section 13808, all new wells that do not meet the exemption criteria must submit <br /> the following required information, to the extent that can be reasonably known. The Environmental Health Department <br /> must collect this information before a new well permit is issued and must post the information on the Department's <br /> website for public information. <br /> EXEMPTION CRITERIA <br /> Well meets the following Exemption: <br /> Well not located in a critically overdrafted basin. <br /> Well owner will be a de minimis extractor: maximum two acre-feet or less per year being extracted for domestic <br /> purposes only. <br /> Replacement well with same extraction as the existing well that it is replacing. The existing well must be <br /> destroyed under permit. <br /> Public agency that substantially meets or exceeds these requirements through another requirement of the law. <br /> In order to be exempt, the applicant shall document the laws that substantially meet or exceed these <br /> requirements and how the requirements of those laws were met. <br /> A city or county municipal well to provide water supply solely for residents of the city or count . <br /> WELL LOCATION AND OWNER INFORMATION <br /> Well'Location Address: IF16 <br /> a�tk✓ -• city:1 YNtt S <br /> Well Location APN: 0'L l- - y ZWell Latitude: � Well Lon itude: ;I Z I.0�3 3z <br /> Flood Plain Designation: <br /> o Well Elevation: ' <br /> Applicant Name: w t+* Applicant Title: <br /> Applicant Address: city: wc <br /> Applicant Phone: — % SS AnNorant email: <br /> Property Owner Name: if <br /> Property -Owner Address:!P.G . Ci w <br /> Property -Owner Phone: 2-'2- SS Pro a Owner email: <br /> PROPOSED WELL-INFORMATION <br /> Well Total Depth(ft): Acres to be Served by Well:1 d <br /> Use of Well: <br /> ❑ Domestic 14 Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> ❑ Other: <br /> Depth of Corcoran Cla ft: <br /> Proposed Well Capacity (gal/ft) 00 vim- Estimated Pumping Rate al/min : a <br /> Antici ated Pumping Schedule al/d Estimated Annual Extraction Volume(acre-feet): <br /> IF <br /> Estimated Cumulative Extraction Volume before January 1,2020 acre-feet: <br /> EXISTING WELLS INFORMATION <br /> Number Existing Wells on Propert : I Please complete the information below for every well on property. Use extra paper if needed. <br /> Well#1 Informatio <br /> S ❑ Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> Use of Well: �-,fJ, k � r � � S vr&-i c>�t— <br /> Other. .-----� --- <br /> Total Depth ft: 200 o: From: <br /> CasingDiameter in : �8(Open Bottom GPScAea ai(ft): To: From: <br /> Pum in Rate m : To: From: <br /> Annual Extraction Volume(acre-feet: p, ( Estimated ❑ Measured <br /> Specific Capacity al/min/ft <br /> Other Pumping Tests-Performed: <br /> Test Result: <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 www.sjcehd.com <br />
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