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A9e4 � 2 � � ^ 50 <br /> 5,� � f QAp�J � ►�f Environmental HealtF� Department <br /> ��J N f Y <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Iication Number: lication T e: <br /> Pro act Adtlress: Pro ed APN: <br /> licant Name- N/A-ATR.T unmanned Telecom facility(Cell site) Title- <br /> Ilcant Atltlress: C /ZI <br /> licant Phone: Email: <br /> Pro a Owner Name: <br /> Pro a Owner Adtlress: Ci /Zi <br /> Pro a Owner Phone: Email: <br /> SERVICES INFORMATION <br /> Please rovitle descri tion below: N/A-ATSaT unmanned Telecom facility(Cell site) <br /> Wa[er Supply: O Sutfaee Water(Attach Wafer Rlghfa/nlormef/on) <br /> Domestic Wastewater Dis oast: <br /> Process Wastewater Oiseha e: Ponds: livable WDR: <br /> Storm Dretne a S stem: <br /> WATER USAGE DATA <br /> ProWde for tote/water use of Wl/bulldouf Number Peraons/Da Gailona/Parson/De Total GellonslDe <br /> Domestic Water Usa e b Em to ea/Customers: <br /> T e of Processllrzi atetl Lantls Total Oailons/De <br /> Process Water Usa e: <br /> Process Water Use e: N/A-AT8eT unmanned Telecom facility(Cell site) <br /> IM atlon Water Usa e: <br /> Total Gallons Par Da <br /> PROPOSED WELL LOCATION <br /> Well Locallon Adtlrosa: CI[y: <br /> Well Locatlon APN- N/A-ATSeT unmanned Telecom facility(Cell site) <br /> Well Latitude: Well Lon (tude: <br /> Flootl Plain Desi nation: Well Eievatlon: <br /> PROPOSED WELL INFORMATION <br /> Well Total De [h ft: Acres[o be Servetl b Well: <br /> Use of Weil: �Domestic O IMgatlon O Smell Public Water Supply O Municipal Public Water Supply O Intlus[rlal O S[od< <br /> O Other. <br /> De th of Corcoran Cla R <br /> Pro osed Well Ca aci al/ft: Estimatetl Pum to Rate al/min <br /> AntlG aced Pum in Schetlule al/tla Estimated Annual 2ctraction Volume acts-feat <br /> Estimated Cumulative Ezbadlon Volume before Janus 1 2020 acre-feet <br /> 81TING INFORMATION <br /> Distance To Nearest R: Onslte: ORelte: Olatanw To Nearest R: Onsite: Offsite: <br /> WastewaterTreatmentS stem: Souroes of Contaminatlon: <br /> Other Wells: N/A-ATR<T unmanned Telecom facility(Cell site) <br /> Sewer Lines: Stream/River: <br /> Animal or Fowl Enclosure: Nevi able Waterwa <br /> Storm Dralna e 5 stem: Po[entlal Rechar a Features: <br /> GROUNDWATER INFORMATION <br /> De th R: 8ource/Date of Referenw: Grountlwater Subbasin: <br /> Curzent Depth to Water: p Cosumnea Subbasin(2-22.16) <br /> Highest Dapih to Water: O Eestem San Joequln Subbasin(5-22.0'1) <br /> Lowest Depth to Water. p Tra Subbasin 5-22.'15 <br /> '1668 E.Hazelton Avanua I Stockton,California 95205 I T 209 466-3420 I F 209 464-Ot38 I www.s{cehtl.com - <br /> tw2 <br />