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SAN JOAQUL Environmenta . health Department <br /> COUNTY <br /> ---- <br /> Greotness grows here . <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number ; Application Type : <br /> Project Address : 11703 W. Larch Road , Tracy , CA 95304 Project APN : 212-180- 12 <br /> Applicant Name : Schack & Company , Inc. Title : Engineer <br /> Applicant Address ; 1025 Central Avenue City/Zip : Tracy, 95376 <br /> Applicant Phone : 209-835-2178 Email : dylan@schackandco . com <br /> Property Owner Name : Mahadeva & Bhanu Ravada <br /> Property Owner Address : 5472 Starflower Way City/Zip ; Livermore , 94551 <br /> Property Owner Phone : 608-381 -5969 or 925-336-5763 Email : ravadasastry@gmail . com <br /> SERVICES INFORMATION <br /> Please provide description below : <br /> Water Supply : New well ❑ Surface Water (Attach Water Rights Information) <br /> Domestic Wastewater Disposal : New septic system <br /> Process Wastewater Dischar e : Ponds : N/A Applicable WDR ; <br /> Storm Drainage System : I Underground storage <br /> WATER USAGE DATA <br /> Provide for total water usage at full buildout Number Persons/Da Gallon s/Person/ Day Total Gallons/Da <br /> Domestic Water Usage by Employees/Customers : 30 20 600 <br /> Type of Process/Irri gated Lands Total Gallons/ Da <br /> Process Water Usage : N/A <br /> Process Water Usage : N/A <br /> Irrigation Water Usage : Landscaping 400 <br /> Total Gallons Per Days l000 <br /> PROPOSED WELL LOCATION <br /> Well Location Address : 11703 W. Larch Road City : j City: Tracy <br /> Well Location APN : 212- 180- 12 <br /> Well Latitude : 37 . 76517898121886 Well Longitude : - 121 .44987113370678 <br /> Flood Plain Designation : Zone AE ( EL 13 feet) Well Elevation : Not determined yet <br /> PROPOSED WELL INFORMATION <br /> Well Total De th (ft) : Not determined Acres to be Served by Well ; 2 . 01 <br /> Use of Well : ❑ Domestic ❑ Irrigation a Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> ❑ Other : <br /> Depth of Corcoran Clay (ft) : Not determined yet <br /> Proposed Well Capacity (gal/ft): Not determined yet Estimated Pumping Rate (gal/min): <br /> Anticipated Pumping Schedule (gal/day): Not determined yet 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) e Onsite : Offsite : Distance To Nearest (ft) : Onsite : Offsite : <br /> Wastewater Treatment System : 1oo' (min) 71000' Sources of Contamination : N/A Not Known <br /> Other Wells : N/A 150' Pond/Lake : N/A N/A <br /> Sewer Lines ; N/A 31000' Stream/ River: N/A 11 , 000, <br /> Animal or Fowl Enclosure : N/A Not Known Navigable Waterway : N/A 11 , 000' <br /> Storm Drainage System : 205' 310001 Potential <br /> Recharge Features ; N/A Not Known <br /> GROUNDWATER INFORMATION <br /> IF Depth (ft) : Source/ Date of Reference : Groundwater Subbasin : <br /> Current Depth to Water : Not determined yet ❑ Cosumnes Subbasin (2-22 . 16) <br /> Highest Depth to Water : Not determined yet ❑ Eastern San Joaquin Subbasin ( 5 -22 . 01 ) <br /> Lowest Depth to Water : Not determined yet 0 Tracy Subbasin (5 -22 . 15 ) <br /> 1868 E . Hazelton Avenue I Stockton , California 95205 T 209 468 - 3420 F 209 464 - 0138 www . sjcehd . com <br /> 1 of 2 <br />