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09/14/2018 07:52 Canepa & Sons (FAX) P.004/010 <br /> SAN )OAQU f N Environmental. Health Department <br /> —COU NTY- <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 /> WELL LOCATION ANIS OWNER INFORMATION O.C1fV <br /> Well Location Address: - Gft)r <br /> Well Location APN: 00 310- 3j - <br /> Well Latitude: �' 71 "Af I Well Longituda:j J21 o ar ar W <br /> Flood Plain Dwignatiom WeII Elevation: <br /> Applicant Name: Canepa and.Sons,Inc. Applicant Tifle:1 Contractor <br /> Applicant Address: 14384 Ciiesta Court City: Sonora <br /> Applicant Phone: (205)532-1136 Applicant email: csonsdrilling(a gmail.wm <br /> Property Owner Name: e'i'li rk <br /> MPfoperty Owner Address: 7-7 ea1.�,t'IQ Imno <br /> - <br /> Property Owner Phone: _ Property 4wneremaii: l!' _� <br /> PROPOSED WELL INFORMATION <br /> Well Total bepth(ft): Acres to-be Served by Well: <br /> Us7orwell, <br /> 0 Domestic X Irrigation Q Small PublicWater Supply p Munlcipal Public Water Supply ❑industrial ❑Stock <br /> Us <br /> ❑Other. <br /> Depth of Corcoran Clay(ft). <br /> Proposed Well Capacity(gallR); Estimated Pumping.Rate(gallmin): -r <br /> Anticipated Pumping Schedule(gaUday): EsUrnated Annual Extraction Volume(.acre-feet):_ ' 1 - <br /> Esornated C rnulative Extraction Volume befereJ.enuary 1,2020(acre-feett U Ilk <br /> EXISTING WELLS INFORMATION <br /> Total Number of Existing Wells on Property: <br /> Please complete the information below for everywell on property. Use utra paper if needed <br /> Well#1 Information <br /> Use of Well: m tiomesdc �irriga$on O Small Public Water Supply Q.Municipal Public Water Supply Elindustrial 0 Stock <br /> Use of Well] <br /> 171 Other: <br /> Total Depth(ft): To: from: <br /> GaslrLq Diameter(in): ❑Open Bottum or Screen interval(ft): To: From:- <br /> Pumping Rate(gpm), To: From: <br /> Annual Extraction Volume(acre-Feel: p Estimated O Measured <br /> Specific-capacity(gal1min/11): <br /> Other Pumping Tests Performed: Test:Result: <br /> 1866 E. Hazelton Avenue I Stockton, California 95205 1 T 209.469-3420 1 F 209 464-0138 1 VA".sjcehd.com <br /> Received Time Sep, 14. 2018 7 : 52AM No, 4137 <br />