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'��C' P� 0 2 6 <br /> lI <br /> Environmental Health De artmenf <br /> SAN�JOAQUIN P <br /> COUNTY <br /> °9croa%� Greatness grows here. <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type: SITE APPROVAL <br /> Project Address: 800 MOSSDALE ROAD,LATHROP,CA 95330 Project APN: 239-030-08 <br /> Applicant Name: MOSSDALE ASSOCIATES LTD. Title: PRESIDENT <br /> Applicant Address: P.O.BOX 1429 City/Zip: LATHROP,CA 95330 <br /> Applicant Phone: (209)993-5208 Email: robert@brownsandinc.com <br /> Property Owner Name: MOSSDALE ASSOCIATES LTD. <br /> Property Owner Address: P.O.Box 1429 City/Zip]LAHTROP,CA 95330 <br /> Property Owner Phone: 209-993-5208 Email:I robert@brownsandinc.com <br /> SERVICES INFORMATION <br /> Please provide description below: PRIVATE WILL FOR DOMESTIC AND IRRIGATION SERVICES <br /> Water Supply: PRIVATE WELL ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: SEPTIC WITH 100%REPLACEMENT <br /> Process Wastewater Discharge: Ponds: I NIA Applicable WDR: <br /> Storm Drainage System: ON-SITE NATURAL <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: a 1 35 280 <br /> Type of Process/irrigated Lands Total Gallons/Da <br /> Process Water Usage: N/A <br /> Process Water Usage: N/A <br /> Irrigation Water Usage: I FOR LANDSCAPING TBD <br /> Total Gallons Per Da 280+LANDSCAPING <br /> PROPOSED WELL LOCATION <br /> Well Location Address: q 4V S W, M 0 5jrdA!e— jFd. I City] LA Th,400F <br /> Well Location APN: a,3rl — C>3c — CFr <br /> Well Latitude: m U '1 Well Lon itude: '}l' ' 5 3.9 1 W <br /> Flood Plain Designation: AE Well Elevation:1 A6' <br /> PROPOSED WELL INFORMATION <br /> Well Total eDew' Acres to be Seryed b Well: <br /> Use of Wetic Orrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑Stock <br /> Depth of Corcoran Clay ft <br /> Proposed Well Capacityal/ft : k�- Estimated Pum in Rate al/min : t}l.YL IZ <br /> Anticipated Pumping Schedule allda 3L2Q j Estimated Annual Extraction Volume acre-feet :l P. <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 S stem: Sources of Contamination: <br /> Other Wells: ' Pond/Lake: SD' <br /> Sewer Lines: 00 ' Stream/River: 310o/ <br /> Animal or Fowl Enclosure: N A Navigable Waterway: <br /> Storm Drainage System:D System: Potential Recharge Features: PIA <br /> GROUNDWATER INFORMATION <br /> Depth(ft): Source/Date of Reference: Groundwater Subbasin: <br /> Current Depth to Water: '3 ►C �G rVLSVeS ❑ Cosumnes Subbasin(2-22.16) <br /> Highest Depth to Water: rV ❑ Eastern San Joaquin Subbasin(5-22.01) <br /> Lowest Depth to Water: Tracy Subbasin(5-22.15) <br /> 1868 E. Hazelton Avenue Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sicehd.com <br /> 1 of 2 <br />