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SANAAQUIN <br />COUNTY - <br />60.p, ureatness grows here. <br />Environmental Heal*E <br />AUG 6 210 <br />New Well Information ENVIRONMENTAL HEALT PERA,IIT/SERVIcFq <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: a.--1 a---1 Q44- ,r012, .0.0,tk.,0 L1/4) ils2, City: IR-exrci <br />Well Location APN: <br />Amyx , Well Latitude: -5-10 35/ sci , 01 ft t,) Well Longitude: 1 7.4 . xi , 2 aciri ,,t.o <br />Flood Plain Designation: ,... Well Elevation: 5! 1.1 <br />Applicant Name: C.,kno )&6(\eed=trb t kir...... it Applicant Title: <br />Applicant Address: 1-1-10 P6wcfaiL09,Stkx4e--' ID° City: 00,A4 /,,SZ, <br />Applicant Phone: cslo) coN,, , 650D Applicant email: <br />Property Owner Name: F\ r1L.5 Arnein CR., <br />Property Owner Address: p, 0. Zozsx 468 City: LatesiA2_) CA.Cia04-0 <br />cric,krkei,ievjcprItscuerertoo Property Owner Phone: (0 ict _GI 5 _ Property Owner email: <br />0 Li PROPOSED WELL INFORMATION <br />Well Total Depth (ft): 10 Acres to be Served by Well: N/A <br />Use of Well: 0 Domestic 0 Irrigation 0 Small Public Water Supply 0 Municipal Public Water Supply 0 Industrial 0 Stock <br />x;) Other: Iv\ OA kl-Dn We.-Al <br />Depth of Corcoran Clay <br />Proposed Well Capacity (gal/ft): w /A Estimated Pumping Rate (gal/min): Mill <br />Anticipated Pumping Schedule (gal/day): t4 /A Estimated Annual Extraction Volume (acre-feet): r•I /A <br />Estimated Cumulative Extraction Volume before January 1, 2020 (acre-feet): ',VA <br />EXISTING WELLS INFORMATION <br />Total Number of Existing Wells on <br />Please complete the information below <br />Property: 10 <br />for every well on property. Use extra paper if needed <br />Well #1 Information k/wo — ( <br />Use of Well: 0 Domestic 0 Irrigation 0 Small Public Water Supply 0 Municipal Public Water Supply , , <br />Ai Other: mom A-Dv-ion we-Al <br />0 Industrial 0 Stock <br />Total Depth (ft): 50 <br />0 Open Bottom or Screen Interval (ft): <br />To: 40 From: SO <br />Casing Diameter (in): a To: From: <br />Pumping Rate (gpm): b.5 /A To: From: <br />Annual Extraction Volume (acre-feet: tJ/A 0 Estimated RI Measured <br />Specific Capacity (gal/min/ft): 0 /A <br />Other Pumping Tests Performed: ,..if,t\ Test Result: <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />)6' CIA kx,tioc ev‘e..401, T6rafAkv.a., 01?