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M2200025 <br /> S A N J O A Q U I N Environmental Health Department <br /> COUNTY <br /> Greatness grows h re <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type: Use Permit <br /> Project Address: 22150 N Kennefick, Acam o, CA 95220 Project APN: 01715001 01715002 I <br /> Applicant Name: Operative Office c/o Michael den Hartog Title: Owner's Re resentive <br /> Applicant Address: 4329 Marmion Way City/Zip: Los Angeles, 90065 <br /> Applicant Phone: 209-224-7412 Email: michael@operativeoffice.com <br /> Property Owner Name: Rodney and Ga la Schatz <br /> —Property Owner Address: 18247 Tretheway Road Cit /Zi : Lockeford CA 95237 <br /> Property Owner Phone: 209-969-2845 Email;I rod@peltierwinery.com <br /> SERVICES INFORMATION <br /> Please provide description below: <br /> Water Supply: Private Well ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: Private Septic <br /> Process Wastewater Discharge: Ponds: lYes A licable WDR: R5-2021-0031 <br /> Storm Drainage System: Conjunction w/wastewater/vineyard 2 acres south end of property <br /> WATER USAGE DATA <br /> Provide for total water usage at full buildout Number Persons/Da Gallons/Person/Da Total Gallons/Da <br /> Domestic Water Usage by Employees/Customers: 25 10 250 <br /> Type of Process/irrigated Lands Total Gallons/Da <br /> Process Water Usage: <br /> Process Water Usage: <br /> Irrigation Water Usage: Separate well for vineyard drip irrigation <br /> Total Gallons Per Day: 250 <br /> PROPOSED WELL LOCATION <br /> Well Location Address: N/A city, <br /> Well Location APN: <br /> Well Latitude: Well Lon itude: <br /> Flood Plain Designation: Well Elevation: <br /> PROPOSED WELL INFORMATION <br /> Well Total Depth ft:N/A Acres to be Served by Well: <br /> Use of Well: <br /> ❑Domestic ❑ Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> ❑ Other: <br /> Depth of Corcoran Clay(ft): <br /> Proposed Well Capacity (gal/ft): Estimated Pumping Rate allmin : <br /> Anticipated Pumping Schedule (gal/day): Estimated Annual Extraction Volume(acre-feet): <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): <br /> SITING INFORMATION <br /> Distance To Nearest(ft): Onsite: Offsite: Distance To Nearest(ft): Onsite: Offsite: <br /> Wastewater Treatment System: N/A Sources of Contamination; <br /> Other Wells: Pond/Lake: <br /> Sewer Lines: StreamlRiver: <br /> Animal or Fowl Enclosure: Navigable Waterway: <br /> Storm Drainage System: i Potential Recharge Features: <br /> GROUNDWATER INFORMATION <br /> Depth(ft): Source/Date of Reference: Groundwater Subbasin: <br /> Current Depth to Water: N/A — d�ostuainaS 5�ue'oasiii�5S�1-�Zhh�Lhh:��� 55 2222Q <br /> B EasTem San Joa uln 5u66asln�5-22.R <br /> owest Hrto iNate. T J�, .1 <br /> 190 6: 09488 A HNB 1918808fl;EBII#8 is 651 r651 f 0$99-NiB P 0 i84=81 A viiv►w sjcelnt.com <br />