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SAN JOANN Ftivirfunmentai Healiliepartme-W <br /> PA2200153 <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type:_ <br /> Pro ect Address; 976 S Gillis Road,Stockton,CA 95215 Project APN: 103-250-14 <br /> Applicant Name: Tanner Young on Behalf of AT&T Title: Applicant <br /> Applicant Address: 22431 Antonio Pkwy,STE 8160-234 Cit /ZI : Rancho Santa Margarita,CA 92688 <br /> Applicant Phone: (714)439-9935 Email: TYOUNG@DERNAGRP.COM <br /> Property Owner Name: SMITH IS LEE TR ETA <br /> Property Owner Address: PO BOX 55282 City/Zip: STOCKTON CA 95205 <br /> Property Owner Phone: Email: <br /> SERVICES INFORMATION <br /> Please provide description below: N/A <br /> Water Supply: N/A ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: N/A <br /> Process Wastewater Discharge: Ponds: I N/A -------TApplicable WDR: N/A <br /> Storm Drainage System: I N/A <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: N/A N/A N/A <br /> Type of Process/Irrigated Lands Total Gallons/Da <br /> Process Water Usage: N/A N/A <br /> Process Water Usage: N/A N/A <br /> Irrigation Water Usage: N/A N/A <br /> Total Gallons Per Day: N/A <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 Longitude:IN/A <br /> Flood Plain Designation: N/A Well Elevation: N/A <br /> PROPOSED WELL INFORMATION <br /> Well Total Drth : N/A Acres to be Served b Well: N/A <br /> Use of Well; mestic ❑ Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> er: <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 N/A Sources of Contamination: N/A N/A <br /> Other Wells: N/A N/A Pond/Lake: N/A N/A <br /> Sewer Lines: N/A N/A Stream/River: N/A N/A <br /> Animal or Fowl Enclosure: N/A N/A Navigable Waterway: N/A N/A <br /> Storm Drainage S Stem: N/A N/A Potential Recharge Features: N/A N/A <br /> GROUNDWATER INFORMATION <br /> Depth(ft): Source/Date of Reference: Groundwater Subbasin: <br /> Current Depth to Water: N/A N/A ❑ Cosumnes Subbasin(2-22.16) <br /> Highest Depth to Water: N/A N/A ❑ Eastern San Joaquin Subbasin(5-22.01) <br /> Lowest Depth to Water: N/A N/A ❑ 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 tivww_�,jc.eiid coin <br /> 1 of 2 <br />