Laserfiche WebLink
A N:J O A Q U N; Environmental Health Department <br /> r 1 <br /> C`O U N.T Y-- <br /> yraws jwrc, <br /> New Well Information <br /> Pursuant to California Water Code, Section 13808, all new wells that do not meet the exemption <br /> criteria must submit the following required information, to the extent that can be reasonably known. <br /> The Environmental Health Department must collect this information before a new well permit is <br /> issued and must post the information on the Department's website for public information. <br /> tIVELLLOATION AND O:WNOR 1NFORMA'TION � <br /> ... <br /> Well Location Address: 983,90 5. 600-w'.,19 00-wio19 + O- City: ES&4'-oN <br /> Well Location APN: .049 <br /> Well Latitude: 3?.;^7i17,03& Well Longitude.T j;tp 9ggvp 2-- <br /> Flood <br /> Flood Plain Designation: Well Elevation: g 3' <br /> Applicant Name: 4" S 3 I-ve. atek0,,, + Applicant Title: JVAIIDr—dr <br /> Applicant Address: /y3$y- Cu c s tk Gj City: 5 0.✓0AA <br /> Applicant Phone: ,zoy S3�-/f3�v Applicant email: sso,6 oAjL41 u 9iy,pic.�b.�i <br /> Property Owner Name: b$6e.4o10 IRAAF04 b AFV- LLG <br /> Property Owner Address: cj3o TRNo t3t„p <br /> Property Owner Phone: CAP,?. .9 f _ Property Owner email: <br /> Well Total Depth(ft):l I Acres to be Served by Well; A�5' <br /> Use of Well: ❑Domestic Kirrigation ❑Small Public Water Supply ❑Municipal Public Water Supply ❑Industrial ❑Stock <br /> ❑Other: <br /> Depth of Corcoran Clay(ft): 1/4 <br /> Proposed Well Capacity(gaUft): Estimated Pumping Rate(gal/min): Soo <br /> Anticipated Pumping Schedule(galtday): 4000 Estimated Annual Extraction Volume(acre-feet): 65 <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): o <br /> EX1SiNG'WELLSITORMAfION , n ; � t rx. <br /> t <br /> Total Number of.Existing Wells on Property: <br /> Please complete the information below for every well on property.Use extra paper if needed <br /> Well#1 Information <br /> Use of Well: ❑Domestic p(lrrigation ❑Small Public Water Supply ❑Municipal Public Water Supply ❑Industrial ❑Stock <br /> ❑Other: Dr-sr" EJ2 <br /> Total Depth(ft): To: From: <br /> Casing Diameter(in): AOpen Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm): To: From: <br /> Annual Extraction Volume(acre-feet: OTEstimated ❑ Measured <br /> Specific Capacity(gallminlft): � <br /> Other Pumping Tests Performed: V/X Test Result: <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />