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SNr'J0A U, N Environmental Health Department <br /> .' ) COUNTY— <br /> ` - <br /> �' ►c,rFosz w"' Greotness 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 /> WELLf.Ol I©N 1ND OILER tNI=0RMk1 I� wr <br /> rNl'L �. G�,:^ _ .'`-_sr .? 4MF'�'h,�' ""iP^V F) 5 <br /> Well Location Address: �� �Lqaa City: <br /> Well Location APN: -�;v � <br /> Well Latitude: Well Longitude: j�] j 1,9.-7:E:, <br /> Flood Plain Designation: Well Elevation: <br /> P V44— <br /> Applicant Name: Can pa and Sons,Inc. Applicant Title: Contractor <br /> Applicant Address: 14384 Cuesta Court City: Sonora <br /> Applicant Phone: (209)532-1136 Applicant email: esonsdrilling@gmail.com <br /> Property Owner Name: <br /> Property Owner Address: City: p� <br /> Property Owner Phone: •/J/® AAM <br /> Property Owner email: y. <br /> 1 <br /> PROPOSEDfW-ELLINFORMATION <br /> Well Total Depth(ft): 3 Acres to be Served by Well:1 Ir <br /> Use of Well: 11Domestic �VIrrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply 1:1Industrial ElStock <br /> ❑ Other: <br /> Depth of Corcoran Clay(ft): <br /> Proposed Well Capacity(gal/ft): �L�i . Estimated Pumping Rate(gal/min): <br /> Anticipated Pumping Schedule(gal 4co g, Estimated Annual Extraction Volume jacce=feet): q,0jkg2A IV <br /> Estimat Cumulative Extraction Volume before January 1,2020 jau:e-fee : <br /> ,EXIS:TING WELLS'IN�C�RMAT,ION �`" <br /> Total Number of Existing Wells on Property: <br /> Please complete the information below for every well on property. Use extra paper if needed <br /> Well#1 Information T-- <br /> Use of Well: ❑ Domestic Xrrigation ❑Small Public Water Supply ❑Municipal Public Water Supply ❑ Industrial ❑Stock <br /> ❑Other: , <br /> Total Depth(ft): /0 f a To: From: <br /> Casing Diameter(in): 1,0 ❑Open Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm): To: From: <br /> Annual Extraction Volume(acre-feet: ,� 12�Estimated ❑ Measured <br /> Specific Capacity(gal/min/ft): <br /> Other Pumping Tests Performed: ( Test Result: <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-34201 F 209 464-0138 1 www.sjcehd.com <br />