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1 , <br /> S A N JOAQUIN Environmental Health Department <br /> Tti' <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: 15833 E St Rt 4 Hy I City:j Stockton,CA <br /> Well Location APN: 18313002 <br /> Well Latitude: Well Longitude: <br /> Flood Plain Designation: Well Elevation: <br /> Applicant Name: Ce li Bros Applicant Title: leaser <br /> Applicant Address: 6161 Cherokee Rd City: Stockton,CA <br /> Applicant Phone: Applicant email: <br /> Property Owner Name: Mount Saint Joseph—Sant Elizabeth <br /> Property Owner Address: 100 Masonic Ave city:1 San Francisco <br /> Property Owner Phone: Property Owner email: <br /> PROPOSED WELL INFORMATION <br /> Well Total Depth(ft): 650 - Acres to be Served by Well: <br /> Use of Well: ❑ Domestic EX Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑Stock <br /> ❑Other: <br /> Depth of Corcoran Clay(ft):n/a <br /> Proposed Well Capacity(gal/ft): Ivo Estimated Pumping Rate(gal/min): `/.40 <br /> Anticipated Pumping Schedule(gal/day): Ig pogo Estimated Annual Extraction Volume(acre-feet): 7W <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): <br /> EXISTING WELLS INFORMATION <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 <br /> Use of Well: ❑ Domestic %Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑Stock <br /> ❑ Other: <br /> Total Depth(ft): To: From: <br /> Casing Diameter(in): 14 ❑Open Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm): 12.pp To: From: <br /> Annual Extraction Volume(acre-feet: '79-0 ti( Estimated ❑ Measured <br /> Specific Capacity(gal/min/ft): /0 <br /> Other Pumping Tests Performed: Test Result: a, <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />