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SAN 10 A Q U I N Environmental Heal t'h Department Water Usage Information PA2200044 PROJECT INFORMATION Application Number: Application Type: Project Address: 12423 S Manthey Road,Lathrop,CA 95330 Project APN: 191-240-130 Applicant Name: Tanner Young on Behalf of AT&T Title: Applicant Applicant Address: 22431 Antonio Pkwy,STE B160-234 City/Zip: Rancho Santa Margarita,CA 92688 Applicant Phone: (714)439-9935 Email: TYOUNG@DERNAGRP.COM Property Owner Name: GIGLICO INC —Property Owner Address: 1112 N MAIN ST 350 City/Zip: MANTECA CA 95336 Property Owner Phone: Email: SERVICES INFORMATION Please provide description below: N/A Water Supply: N/A ❑ Surface Water(Attach Water Rights Information) Domestic Wastewater Disposal: N/A Process Wastewater Discharge: Ponds: N/A Applicable WDR: N/A Storm Drainage System: N/A WATER USAGE DATA Provide for total water usage at full buildout Number PersonslDa Gallons/Person/Da Total Gallons/Da Domestic Water Usage by Employees/Customers: N/A N/A N/A Type of Process/Irrigated Lands Total Gallons/Da Process Water Usage: N/A N/A Process Water Usage: N/A N/A Irrigation Water Usage: N/A N/A Total Gallons Per Day: I N/A PROPOSED WELL LOCATION Well Location Address: N/A I City: N/A Well Location APN: N/A Well Latitude: N/A Well Lon itude: N/A Flood Plain Designation: N/A Well Elevation: N/A (PROPOSED WELL INFORMATION Well Total Depth(ft):1 N/A I Acres to be Served by Well: N/A Use of Well: ❑ Domestic ❑ Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock ❑ Other: Depth of Corcoran Clay(ft): N/A Proposed Well Capacity (gal/ft): N/A Estimated Pumping Rate (gal/min): N/A Anticipated Pumping Schedule allda : N/A Estimated Annual Extraction Volume acre-feet: N/A Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): N/A SITING INFORMATION Distance To Nearest(ft): Onsite: Offsite: Distance To Nearest(ft): Onsite: Offsite: Wastewater Treatment System: N/A N/A Sources of Contamination: N/A N/A Other Wells: N/A N/A Pond/Lake: N/A N/A Sewer Lines: N/A N/A Stream/River: N/A N/A _ Animal or Fowl Enclosure: N/A N/A Navigable Waterway: N/A N/A Storm Drainage S stem: N/A N/A Potential Recharge Features: N/A N/A GROUNDWATER INFORMATION Depth(ft): Source/Date of Reference: Groundwater Subbasin: _ Current Depth to Water, N/A N/A ❑ Cosumnes Subbasin(2-22,16) Highest Depth to Water, N/A N/A ❑ Eastern San Joaquin Subbasin(5-22.01) Lowest Depth to Water: N/A N/A ❑Tracy Subbasin(5-22.15) 1868 E. Hazelton Avenue I Stockton, Califoinia 95205 1 T 209 468-3420 1 F 209 464-0138 1 www sicend coni 1 of 2