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SAN J O A Q U I N Environmental Health Department Water Usage Information PROJECT INFORMATION Application Number: Application Type: Pro'ect Address: 6125 W Banner Street,Lodi,CA 95242 Pro'ect APN: 0551-320-66 Applicant Name: DaHd-8Wke1tyALt,Chandrakant Patel 8 Jai Patel Title: Maipal Architect Applicant Address: 17071NStmabnt Street City/.Zip: lllbd>Wo,MM354 Applicant Phone: (mg)fsp soo Email: jaipatel56@yahoo.com Property Owner Name: PDK Hospitality LLC —Property Owner Address: 1707 w Fremont Street City/Zip: Stockton 95203 Property Owner Phone: (209)483-6719 Email: dlauMLD@A&camhitects.com SERVICES INFORMATION Please provide description below: Water Supply: County Service Area 31 ❑ Surface Water(Attach Water Rights Information) Domestic Wastewater Disposal: County Service Area 31 Process Wastewater Discharge: Ponds:T Applicable WDR: Storm Drainage System: I County Service Area 31 WATER USAGE DATA Provide for total water usage at full buildout Number Persons/Da Gallons/Person/Da Total Gallons/Da Domestic Water Usage by Employees/Customers: 4 Employees+130 avg guests 150 6,700 estimate Type of Process/Irrigated Lands Total Gallons/Day Process Water Usage: NIA Process Water Usage: N/A Irrigation Water Usage: N/A Total Gallons Per Day: 6,700 estimate PROPOSED WELL LOCATION Well Location Address: NIA 1 City: Well Location APN: Well Latitude: Well Longitude: Flood Plain Designation: Well Elevation: PROPOSED WELL INFORMATION Well Total Depth(ft):1 I Pares to be Served by Well: Use of Well: ❑ Domestic ❑ Irrigation ❑ Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock ❑ Other: Depth of Corcoran Clay(ft): Proposed Well Capacity(gal/ft): Estimated Pumping Rate(gal/min): Anticipated Pumping Schedule(gal/day): Estimated Annual Extraction Volume(acre-feet): Estimated Cumulative Extraction Volume before-January 1,2020(acre-feet): SITING INFORMATION - Distance To Nearest(ft): Onsite: Offsite: Distance To Nearest(ft): Onsite: Offsite: Wastewater Treatment System:-N/A Adjacent Street Sources of Contamination: N/A N/A Other Wells: N/A N/A Pond/Lake: N/A N/A Sewer Lines: NIA Adjacent Street Stream/River: N/A N/A Animal or Fowl Enclosure: N/A N/A Navigable Waterway: N/A N/A Storm Drainage System: N/A Adjacent Street Potential Recharge Features: N/A N/A GROUNDWATER INFORMATION Depth(ft): Source/Date of Reference: Groundwater Subbasin: Current Depth to Water: ❑ Cosumnes Subbasin(2-22,16) Highest Depth to Water: ❑ Eastern San Joaquin Subbasin(5-22.01) Lowest ep o a er: ❑Tracy Subbasin(5-22.15) 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 ( F 209 464-0138 1 www.sjcehd.com 1 of 2