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, IJ/ .' SAN JOAQUIN \Ql~Zlijij(Q)~~ Environmental Health Department ,,, I ; -COUNTY-Water Usage Information PROJECT INFORMATION Application Number: Application Type: Master Plan / Site Approval Project Address: 11050 W. Acker Island, Stockton, CA 95219 Project APN: 131-020-01 Applicant Name: Lost Isle Resort, LLC / David Wheeler CEO Title: CEO Applicant Address: 1475 Saratoga Ave, Suite 100 City/Zip: San Jose, CA 95129 Applicant Phone: 408-836-4427 Email: Dave@MuddyRiverCapital.com Property Owner Name: Lost Isle Resort, LLC / David Wheeler CEO Property Owner Address: 1475 Saratoga Ave, Suite 100 I City/Zip: San Jose, CA 95129 Property Owner Phone: 408-836-4427 I Email: GLabrie@dcceng.net or Bmcgowan@dcceng.net SERVICES INFORMATION Please provide description below: Water Supply: Private, Domestic Well □ Surface Water (Attach Water Rights Information) Domestic Wastewater Disposal: On-Site wastewater storage and off-site wastewater disposal. Process Wastewater Discharge: Ponds: I I Applicable WDR: I Storm Drainage System: Natural WATER USAGE DATA Provide for total water usage at full buildout Number Persons/Day I Gallons/Person/Day Total Gallons/Day Domestic Water Usage by Employees/Customers: 600 I 3 1800 Type of Process/Irrigated Lands Total Gallons/Day Process Water Usage: Process Water Usage: Irrigation Water Usage: Non-Potable water for watering plants and washing down facilities 5400 I Total Gallons Per Day: 7200 PROPOSED WELL LOCATION Well Location Address: I C.ity:I Well Location APN: Well Latitude: Well Lonqitude:I Flood Plain Designation: Well Elevation:! PROPOSED WELL INFORMATION Well Total Depth (ft):I I Acres to be Served by Well:I Use of Well: □ Domestic □ Irrigation D Small Public Water Supply □ Municipal Public Water Supply □ Industrial D Stock D Other: Depth of Corcoran Clay (ft): Proposed Well Capacity (gal/ft): Estimated Pumpinq Rate (qal/min): Anticipated Pumping Schedule (gal/day): Estimated Annual Extraction Volume (acre-feet): Estimated Cumulative Extraction Volume before January 1, 2020 ( acre-feet): SITING INFORMATION Distance To Nearest (ft): Onsite: Offsite: Distance To Nearest (ft): Onsite: Offsite: Wastewater Treatment System: N/A Sources of Contamination: other Wells: Pond/Lake: Sewer Lines: Stream/River: Animal or Fowl Enclosure: N/A Navigable Waterway: Storm Drainaqe System: Potential Recharge Features: GROUNDWATER INFORMATION Depth (ft): Source/Date of Reference: Groundwater Subbasin: Current Depth to Water: □ Cosumnes Subbasin (2-22.16) Highest Depth to Water: □ Eastern San Joaquin Subbasin (5-22.01) Lowest Depth to Water: □ Tracy Subbasin (5-22.15) 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com 1 of 2