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1PIA7 20 004 � <br /> SAN 10AQUIN Environmental Health Department <br /> COUNTY— <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type: Master Plan/Site Approval <br /> Project Address: 11050 W.Acker Island,Stockton,CA 95219 Project APN: 131-020-01 <br /> Applicant Name: Lost Isle Resort,LLC/David Wheeler CEO Title: CEO Applicant Address: 1475 Saratoga Ave,Suite 100 City/Zip: San Jose,CA 95129 <br /> Applicant Phone: 408-836-4427 Email: Dave@MuddyRiverCapital.com <br /> Property Owner Name: Lost Isle Resort,LLC/David Wheeler CEO <br /> Property Owner Address: 1475 Saratoga Ave,Suite 100 City/Zip: San Jose,CA 95129 <br /> Property Owner Phone: 408-836-4427 Email: GLabrie@dcceng.nelorBmcgowan@dcceng.net <br /> SERVICES INFORMATION <br /> Please provide description below: <br /> Water Supply: Private, Domestic Well ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: On-Site wastewater storage and off-site wastewater disposal. <br /> Process Wastewater Discharge: Ponds: Applicable WDR: <br /> Storm Drainage System: Natural <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: 600 <br /> Type of Process/Irrigated Lands Total Gallons/Da <br /> Process Water Usage: <br /> Process Water Usage: <br /> Irrigation Water Usage: Non-Potable water for watering plants and washing down facilities 5400 <br /> Total Gallons Per Day: 7200 <br /> PROPOSED WELL LOCATION <br /> Well Location Address: I Cit <br /> Well Location APN: <br /> Well Latitude: Well Longitude: <br /> Flood Plain Designation: Well Elevation: <br /> PROPOSED WELL INFORMATION <br /> Well Total Depth(ft):1 Acres to be Served by Well: <br /> Use of Well: ❑ Domestic ❑ Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> ❑ Other: <br /> Depth of Corcoran Clay ft: <br /> Proposed Well Capacity al/ft: Estimated Pumping Rate (gal/min): <br /> —Anticipated Pumping Schedule alida : 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: NIA Sources of Contamination: <br /> Other Wells: Pond/Lake: <br /> Sewer Lines: Stream/River: <br /> Animal or Fowl Enclosure: N/A Navigable Waterway: <br /> Storm Drainage System:System:j Potential Recharge Features: <br /> GROUNDWATER INFORMATION <br /> Depth ft: Source/Date of Reference: Groundwater Subbasin: <br /> Current Depth to Water: ❑Cosumnes Subbasin(2-22.16) <br /> Highest Depth to Water: ❑ Eastern San Joaquin Subbasin(5-22.01) <br /> Lowest Depth to Water: ❑Tracy Subbasin(5-22.15) <br /> 1868 E. Hazelton Avenue l Stockton, California 95205 l T 209 468-3420 l F 209 464-0138 1 www.sicehd.com <br /> 1 of 2 <br />