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aU+" <br /> SAN JOAQUIN Environmental Health Department <br /> z. <br /> COUNTY <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: PA-2200142 Application Type: I STAFF APPROVAL <br /> Project Address: 6125 w Banner Street,Lodi,CA 95242 Project APN: 055-320-66 <br /> 1 Applicant Name: David Burkett,AIA Title:I Principal Architect <br /> Applicant Address:1 1217 J Street City/Zip:I Modesto,CA 95354 <br /> Applicant Phone: (209)522-8900 Email:I jaipatel56@yahoo.com <br /> Property Owner Name: PDK Hospitality LLC <br /> Property Owner Address: 1707 w Fremont street Cit /ZI Stockton 95203 <br /> Property Owner Phone: (209)483-6719 Email:I david@redincarchitects.com <br /> SERVICES INFORMATION <br /> Please provide description below: <br /> Water Supply: County Service Area 31 ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: County Service Area 31 <br /> Process Wastewater Discharge: Ponds: I I A licable WDR: <br /> Storm Drainage Sys em: County Service Area 31 <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: 4 Employees+130 avg guests 150 6,700 estimate <br /> Type of Process/Irrigated Lands Total Gallons/Day <br /> Process Water Usage: N/A <br /> Process Water Usage: N/A <br /> Irrigation Water Usage: N/A <br /> Total Gallons Per Day: 6,700 estimate <br /> PROPOSED WELL LOCATION <br /> Well Location Address: N/A I Cit : <br /> Well Location APN: <br /> Well Latituded I Well Longitude: <br /> Flood Plain Designationj I Well Elevation: <br /> PROPOSED WELL INFORMATION <br /> Well Total De th ft : Acres to be Served b Well: <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): <br /> Proposed Well Capacity (gal/ft): Estimated Pumping Rate (gal/min): <br /> Anticipated Pumping Schedule (gal/day): 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: N/A Adjacent Street 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 Adjacent Street Stream/River: N/A N/A <br /> Animal or Fowl Enclosure: N/A N/A Navigable Waterway: N/A N/A <br /> Storm Drainage System: N/A Adjacent Street Potential Recharge Features: N/A N/A <br /> GROUNDWATER INFORMATION <br /> De th 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 I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.socehd.com <br /> 1 of 2 <br />