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° ' SAN � IOAQUIN p <br /> k �ti Environmental Health Department <br /> �! !49" `' COUNTY <br /> L���Foaa�P Greatness grows here. <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: 19812 Gawne Rd CitYj Escalon <br /> Well Location APN: 18510002 <br /> Well Latitude: Well Longitude: <br /> Flood Plain Designation: Well Elevation: <br /> Applicant Name: Lance Ioppini Applicant Title: owner <br /> Applicant Address: PO Box 1229 City: Ripon <br /> Applicant Phone: 209-531 -7879 Applicant email: <br /> Property Owner Name: same <br /> Property Owner Address: City: <br /> Property Owner Phone: Property Owner email: <br /> PROPOSED WELL INFORMATION <br /> Well Total Depth(ft):1 I Acres to be Served by Well: <br /> Use of Well: ❑ Domestic 0 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(gal/min): <br /> Anticipated Pumping Schedule(gal/day): Estimated Annual Extraction Volume(acre-feet): <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): t,5+Zeof It To: A/A From: <br /> Casing Diameter(in): atet C' ❑ Open Bottom or Screen Interval(ft): To: YA From: <br /> Pumping Rate(gpm): Sf To: AlAt From: <br /> Annual Extraction Volume(acre-feet: .�SPG r--} '®_Estimated ❑ Measured <br /> Specific Capacity(gal/min/ft): 1.5 cv+ <br /> Other Pumping Tests Performed: Test Result: <br /> 1868 E. Hazelton Avenue 1 Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />