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SANJOAQUIN Environmental Health Department <br /> COUNTY <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 <br /> criteria must submit the following required information, to the extent that can be reasonably known. <br /> The Environmental Health Department must collect this information before a new well permit is <br /> issued and must post the information on the Department's website for public information. <br /> �WE�i..ZL0��i01�`A1!1�• E .1w� C�N;N ', ;�;�;:::;- n,•.;. � -; <br /> Well Location Address: ftor g, R.&.H Ao C1tY:j f„A jTCr-4 <br /> Well Location APN: <br /> Well latitude:3'1 e 5 °I•Z4' nl Well Longitude: lzt`IS` jq.Ot e W <br /> Flood Plain Designation: 2,,,4 x Well Elevation: <br /> Applicant Name: ' h Applicant Title: C o- <br /> Applicant Address: aAk VX YUe43653 City: <br /> Applicant Phone: X09 -( g Applicant email:ilkl s 6m.cc,,, <br /> Property Owner Name: GivN�4,gP, ?a%tA r pg4cR g,at n in <br /> Property Owner Address: lbog6 sw." tom City: OAS, 18.0-aby- tL„ <br /> Property Owner Phone: a la. -4111.0 a Property Owner email:2 ,. e7G�. t en <br /> PRQP <br /> QsEMVnf��� sol 'BION.' <br /> Well Total Depth(ft): Zso Acres to be Served by WeU:l Ma Ar, <br /> Use of Well: [3 Domestic X Irrigaticn ❑Small Public Water Supply ❑Municipal Public Water Supply ❑Industrial ❑Stock <br /> Depth of Corcoran Clay(ft): UNk na..-+n <br /> Proposed Well Capacity(gal/ft): Estimated Pumping Rate(gaftn): Z-1p„- <br /> Anticipated Pumping Schedule(gai/day): 2-14, M e Va+� Estimated Annual Extraction Volume{acre-feet)' 14�Aa- <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet):201-1 #%-L-�-t- ^jm <br /> Total Number of Existing Wells on Property: <br /> Please complete the infaIrmation below for every well on property.Use extra paper if needed <br /> Well#1 Information <br /> Use of Well: ❑Domestic ❑ Irrigation ❑Small PubAc Water Supply ❑Municipal Public Water Supply ❑ Industrial ❑Stock <br /> other , �i.-" <br /> Total Depth(ft):Virtu vw, To: From: <br /> Casing Diameter(in): " ❑Open Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm): Na PjMP To: From: <br /> Annual Extraction Volume(acre-feet: stet'fd osa ❑ Estimated ❑ Measured <br /> Specific Capacity(gal1min/ft): rt A,. <br /> Other Pumping Tests Performed: o/A► Test Result <br /> 1868 E. Hazelton Avenue I Stockton,California 952051 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />