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" ` 2 0 0 15 8 <br /> SAN J O A Q U I N Environmentall Health Department <br /> COUNTY <br /> re - n s c rows here <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type: SITE APPROVAL <br /> Project Address: 645 Yettner Road,French Camp,CA.95231 Project APN: 193-060-450 <br /> Applicant Name: Gurpartap Singh Title: MR. <br /> Applicant Address: 62 North Sierra Madre Street City/Zip: Mountain House/95391 <br /> Applicant Phone: 925 724-8010 Email: garybizl@yahoo.com <br /> Property Owner Name: Gurpartap Singh <br /> Property Owner Address: 62 North Sierra Madre Street City/Zip: Mountain House/95391 <br /> Property Owner Phone: 925 724-8010 Email: taisingh@jsdrayage.com&garys@jsdica.com <br /> SERVICES INFORMATION <br /> Please provide description below: <br /> Water Supply: NONE AND NOT PROPOSED AT THIS TIME ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: NONE AND NOT PROPOSED AT THIS TIME <br /> Process Wastewater Discharge: Ponds: I N/A Applicable WDR: I N/A <br /> Storm Drainage System: ON-SITE BASIN <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: NONE NONE NONE <br /> Type of Process/irrigated Lands Total Gallons/Da <br /> Process Water Usage: N/A <br /> Process Water Usa e: N/A <br /> Irrigation Water Usa e: N/A <br /> Total Gallons Per Day: NONE <br /> PROPOSED WELL LOCATION <br /> Well Location Address: N/A I City: N/A <br /> Well Location APN: N/A <br /> Well Latitude: N/A Well Lon itude: N/A <br /> Flood Plain Designation: N/A Well Elevation: N/A <br /> PROPOSED WELL INFORMATION <br /> Well Total De th ft: N/A Acres to be Served b Well: N/A <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): N/A <br /> Proposed Well Capacity (gal/ft): N/A Estimated Pumping Rate (gal/min): N/A <br /> Anticipated Pumping Schedule (gal/day): N/A Estimated Annual Extraction Volume(acre-feet): N/A <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): N/A <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: N/A <br /> Other Wells: N/A Pond/Lake: N/A <br /> Sewer Lines: N/A Stream/River: N/A <br /> Animal or Fowl Enclosure: N/A Navigable Waterway: N/A <br /> Storm Drainage System: N/A Potential Recharge Features: N/A <br /> GROUNDWATER INFORMATION <br /> Depth(ft): Source/Date of Reference: Groundwater Subbasin: <br /> Current Depth to Water: 48+/- SJ GW Sustain. Report 2022 ❑ Cosumnes Subbasin(2-22.16) <br /> Highest Depth to Water: 28+/- SJ GW Sustain. Report 2022 11 Eastern San Joaquin Subbasin(5-22.01) <br /> Lowest Depth to Water: 50+/- SJ GW Sustain. Report 2022 ❑Tracy Subbasin(5-22.15) <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sucehd.com <br /> 1 of 2 <br />