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SAN J QAQ U I „ E,nvironmentc.. Health Department CC-)UNT'Y Water Usage Information PA e U O U 14 0 PROJECT INFORMATION Application Number: Application Type! Site Approval 1 Ag Waste Processing Pro ect Address; 74378 E.Brandt Road,Clements,CA 95277 Pr2ct APN: 0231a003 Applicant Name: Elder Creek Transfer&Recovery Inc.,Corp. Title: Applicant Address: 2aa76 Brandt Road Ci# IZi : Lodi,CA 95240 Applicant Phone. (760)272-1224 Email;I csenay@reputilicservices.com Property Owner Name: Gary c.save,sr.,Trustee PropertyP(operty Owner Address: 11540 Clay stailon Flaad Liit /Zi 7prHerald,CA 95638 Property Owner Rhone; (209)993-6004 Email; s4ivaranchasOyahco.com SERVICES INFORMATION Please provide description below: Water Supply: private, existing water well ❑ Surface Water(Attach Water Rights Information) Domestic Wastewater Disposal: Portable resirooms;haul or transfer to dump station Process Wastewater Discharge: Ponds: Applicable WDR: Storm Drainage System: WATER USAGE DATA Provide for total water usage at full buildout Number Persons/Da Gallons/Person/Day Total Gallons/Da Domestic Water Usage by Employees/Customers: 10 15 150 Type of Process/Irrigated Lands Total Gallon0a Process Water Usage; Dust Cpntroi Purposes 10,000 Process Water Usage: Irrigation Water Usage: Total Gallons Per Day: 10,150 PROPOSED WELL LOCATION Wel(Location Address: N/A I Cit Well Location APN: Well Latitude; Well Lon itude: Flood Plain Designation: Well Elevation: PROPOSEID WELL INFORMATION Well Total Depth(ft):1 Acres to be Served by Well: Use of Well: ❑ Domestic ❑ Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock ❑ Other: Depth of Corcoran Cls (ft): Proposed Well Capacity allft: Estimated Pumping Rate allmin : Anticipated Pumping Schedule allda : Estimated Annual Extraction Volume(acre-feet): Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): SITING INFORMATION Distance To Nearest ft : Onsite: Offsite: Distance To Nearest(ft),, Onsite: Offsite: Wastewater Treatment S s#em: NIA N/A Sources of Contamination: WA NIA Other Wells: NA 1,200 ft.;6,000 ft. Pond/Lake. NIA NIA Sewer Lines: N/A NIA Stream/River; NIA NIA Animal or Fowl lEnclosured 10 ft 1,100 fl Navigable Waterwa ; NIA NIA Storm Oraina a Cu stem: N/A NIA Potential Recharge Features: 400 ft. NIA GROUNDWATER INFORMATION Depth(ft): SourcelDate of Reference: Groundwater Subbasin: Current Depth to Water: Not available ❑ Cosumnes Subbasin(2-22.16) Highest Depth to Water: Not available 11 Eastern San Joaquin Subbasin(5-22.01) Lowest Depth to Water: Not available 0 Tracy Subbasin(5-22.15 'I868 L. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 vvww.sjcelid.com 1 of 2