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3A N J OAN N Environmental Health Department <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 AND OWNER INFORMATION <br /> Well Location Address 8000 Hw 120 1 City: <br /> Escailon 95320 <br /> Well Location APN:2 4 9-0 2 0-0 6 <br /> Well Latitude: 3 7 7 9 4 9 2 4 Well Longitude:1 190 - 96 <br /> Flood Plain Designa�Kb Joaquin Val I ay—Paster <br /> ll Elevation: <br /> Applican Applicant Title: <br /> i't�i'n s Bros. Drilling Co. Inc. pp <br /> Applicant Address:1930 Ladd Rd. City: Modesto <br /> t Applicant Phone: 545-1185 Applicant em <br /> Property Owner Narrq. nd ley Family 2013 Trust <br /> Property Owner Addres 6590 S. Murphy Rd. <br /> City: E sc a lon 95320 <br /> Property Owner Phone: Property Owner em4rnhendle @ gmai 1. <br /> PROPOSED WELL INFORMATION <br /> Well Total Depth(ft): 4 0 0 Acres to be Served by Well: <br /> �— ❑Domestic L�Xrrigation C Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑Stock <br /> Use of Well: <br /> ❑ Other. <br /> Depth of Corcoran Clay(ft): <br /> Proposed Well Capacity(gal/ft):l Estimated Pumping Rate(gal/min): <br /> Anticipated Pumping Schedule(gallday):I Estimated Annual Extraction Volume(acre-feet): <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): <br /> EXISTING WELLS INFORMATION <br /> i <br /> Total Number of Existing Wells on Property: 1 <br /> Please complete the information below for every well on property. Use extra paper if needed <br /> Well#1 Information <br /> Use of Well: <br /> CjkDomestic ❑ Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial E Stock <br /> ❑ Other: <br /> Total Depth(ft): To: From: <br /> _Casing Diameter(in): ❑Open Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm): To: From: <br /> Annual Extraction Volume(acre-feet: ❑ Estimated ❑ Measured <br /> Specific Capacity(gal/minlft): <br /> I Other Pumping Tests Performed:, Test Result: <br /> 1368 E Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 ! .vvvvv.sjcehd.corn <br />