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SA\ JOAQUIN
<br />
<br />'Thvironmental Heath Department
<br />OUNTY---
<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: 2_10 \ 1- c"..-c. ivv-rtc.c-V... 17..,) c,( \ c.‘ 1 City:
<br />Well Location APN: c:,) ci 1 .-?-
<br />Well Latitude: -:--, B ° a' ?"7, 0 7 4s" IN1 ---'` Well Longitude: \ -2._ \ ' 3 3 p, 2 (=ID 42' 'v.1
<br />Flood Plain Designation: x (S0,0) Well Elevation: i ‘
<br />-* 39,, I) .4,-
<br />Applicant Name: Do, c 0, k %, -‘, L-"::" ‘ ej Ch. (I; Applicant Title:1'7,r ,.,,, tt..e....
<br />Applicant Address: p, c), "e3c) ys C., 't-35 City:
<br />Applicant Phone: ( z,c,9 ) c:±3,E; / - 2, irit.... Applicant email:
<br />qe.c12.1::'11, A e-t-
<br />Property Owner Name: \i,jc_ ..! bc,t-k p.,.(v_k e„c.:.,,A -7.,;(-<..../c,c,-...\0\ e... t_._, q 'I N-N,i --‘"--1- 0 '-_,T l`i di' t
<br />Property Owner Address: V.). C) boy, .....1 /4-,5L . *Y:
<br />Property Property Owner Phone: ( 2:c.,(A) ?,8---i_j.-_,,.2...tic, Property Owner email: cx
<br />,
<br />I PROPOSED WELL INFORMATION
<br />Well Total Depth (41 I Acres to be Served by Well: (.C.;
<br />Use of Well:
<br />0 Domestic Xrrigation 0 Small Public Water Supply 0 Municipal Public Water Supply 0 Industrial
<br />ID Other: Orcsno.rcks)
<br />0 Stock
<br />Depth of Corcoran Clay (ft):!
<br />Proposed Well Capacity (gal/ft):, Estimated Pumping Rate (gal/min): 7 "3 \
<br />Anticipated Pumping Schedule (gal/day): 1 . o 5 tv\ , Estimated Annual Extraction Volume (acre-feet):! cl, 7,
<br />Estimated Cumulative Extraction Volume before January 1, 2020 (acre-feet):! F<
<br />EXISTING WELLS INFORMATION
<br />Total Number of Existing Wells on
<br />Please complete the information below
<br />Property: -3
<br />for every well on property. Use extra paper if needed
<br />Well #1 Information (L-- o a. 1 Y"-\ -C-0\•.! 20\ 9/ ONO (:) 1-e-1-e_ c\ e. -A-c, cAroV) 1 'n NAickA•eY"-- tr-kb
<br />---er'-\''°\3 `-.
<br />Use of Well:
<br />0 Domestic Imgation 0 Small Public Water Supply 10 Municipal Public Water Supply 0 Industrial 0 Stock
<br />cvsiv, Yi\c5-kx--
<br />0 Other:
<br />Total Depth (ft): ,.. '‘).,5-
<br />0 Open Bottom or Screen Interval (ft):
<br />To: From:
<br />Casing Diameter (in): l Z. 713 C.: D To: From:
<br />Pumping Rate (gpm): iN2g ,4. To: From:
<br />Annual Extraction Volume (acre-feet: IV /is.. 0 Estimated 0 Measured
<br />Specific Capacity (gal/min/ft): INA/ A.
<br />Other Pumping Tests Performed: 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
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