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09/14/2016 07:52Canepa & Sons (FAX) P.004/010 <br /> SAN JOAQUIN Environmental Health Department <br /> —COU NTY- <br /> New Well Information <br /> .Pursuant to California 1Vater Code, Section 13808, all new weals that do not meet the exemption <br /> criteria must submit the follcvving 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 Departmen'Ls website for public information. <br /> WELL LOCATION AND OWNER INFORMATION <br /> Well J_ocation Address: T�501 <br /> We11 Lantuda ,�)�' " Well LongitL�a: fes' �' 2" 1N. <br /> Fkod Plain Desigratiom Neil�!eva+��1:1 <br /> Applicant Na:r:E: Cunepa snd Sons,Inc. Applicant Ti9e Contmctor <br /> ApplicartAddress; 14384 Cuesta Court Gly SODOM <br /> Applicant Phone (249)t32-11.36 Appb=t amall: esonzdri11in9@.9mzi1.c*m <br /> Properly Owner Name.1 IV rj <br /> Prop_"Owner Address r"1.-7 Ea je { <br /> Property Owner Phone: i Property Own eremaii WIM, <br /> PROPOSED WELL INFORMATION <br /> Well Total 13epth(r1):l I / Acres tobe Served by Wejl: <br /> Use 04,Wei 1: D Domestic '41.rrigskn 0 Sntall Public Water Suppty p hlunicipaJ Publlc.Wata Supply O Industrial D Stock <br /> 0 Other: <br /> Depth of Corcoran Clay{it)° <br /> Praised Well Capzcfty(gallft}. Estimated Pumping Rate(gai3mit3j: r <br /> Ant cipated Prirtpsnc Sc`r°tiure(gatldo^/): v =stLrtated Annual Extractiot Vol rDe(atxe-toot}: _(k <br /> Esfrrr aed raulisrc Furan Volume befareJararary a,ZQ2(t(stxe-fe �v' L' - <br /> DQSTING WELLS KFORMATION <br /> Total Number of EAsting Wells on Propery: —4:V <br /> Pieasp xmpiete the informaton beiow.for every.well on property, use extra pacer if needed <br /> Weil Irr1 infontiation I <br /> Use of WeiC� O Dornesoc .D irrfgalron D Small Pubt Water Supply i7 municipal Public Water Supply D industrial ❑Stock' <br /> l ^Other. <br /> -1 OW Depih(ft): To: From: <br /> Casing Diameier(ir):l D Open Sottcm er Screen interval(ft): 'a From: � <br /> Putrping Rafe(gpmr C To: From: <br /> ,annual Extradiion Volume(acre-feed, Estlmatzd a lvlessured <br /> SpeffZ.CapB*(g@VMin/ft):j <br /> 177 Pumping Tests Pedommed:i Test ResuJ�( J <br /> 9868 E. Hazedon Aveneze 1 Stockton, Cetifamia 95205 l T 209.46:3-3420 1 F 209 464-0938 i vnattiv.sjcehd.corn <br /> Received Time Sep. 14. 2018 7:52AM No. 4137 <br />