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i <br /> - -- - <br /> V1. V N7714ry <br /> Av.w.Oa I O. OCSIGX ILOM �M YGO ' <br /> •. l r.a.r..r I \ <br /> T of{O <br /> DAILY ID. 1'. MGDI: <br /> 1 . 005 MGD 1 . 004 MGD .005 MGD <br /> C• SONO RASTC On PC.ALI ewll..u....... 1 .e...�..arc.oa..... a - I .o..♦•• ••w• <br /> SITE 11.TONS OR <br /> 1 IIN caval <br /> I' ON <br /> VII. LOCATION Or ro1MT or OISIo{pl oR o <br /> 10{aIOM AMO ATTACH Al,YSKETCH,OR LOCATION ON Y.t.O.a.OVAORANOL{ YAI• l..ON 1. YINVT{fCRI{f.l RAM6{, BASE /.NO MERIDIAN: <br /> LIST DISTANCES OR {{ARIMO AMC DISTANCE FROM SECTION CORN{N ON OYANTCR CORNER,SCCTION,TOW NSM II, <br /> See Report <br /> —' — vul "U.Ce o♦wwr{w SUIILY Ic..c TNI <br /> A. MUNICIPAL OR UTILITY SERVICE: 5. ❑ INDIVIOUAL(Welis) ' <br /> w.r... W..A.......ew C. F� SURFACE SUPPLY: <br /> I...F..TE. N ; _A.N.wl.......rl.e. .Ia...N . <br /> Riparian {� Appropriation 1 <br /> I <br /> IJI. CMVIRONMCMTAL IYIKT R6IORT I <br /> Hes an EIR been prepared for this 1101SCi? Yet No <br /> if"Yes plow Enclose a copy. <br /> If"No"' will an EIR W"PSrad7 F� Yee No <br /> Will a negative decle ration b prepared? Yn No .r.....e. <br /> If"Yes".plaue answer the following: r5.w I......I...... <br /> .w...c. m.I •••'•.•^'• ^• <br /> San Joaquin County <br /> CERTIFICATION <br /> hereby certify under penalty of perjury that the information provided in this application and in any attach- <br /> ments is true and accurate to the best of my knowledge. <br /> .,W.. or 1=1 IL,TY nO AT... OI FCw ATO. OR sAculrr <br /> ? w.e..o.....e.... <br /> ocu.✓ I.LN o w..� Gi" <br /> 'LIfT TITLES DI ANY ATTACHMENTS: -- - _--- — <br /> Listed in report <br /> You will be notified Of the corracbhen of filing lee aIW submittal of any additieRY inlOrmanon deemed necessary m DomDleta voyr Report of Wavle <br /> Discharge Pursuant to Division 7• Sactlon 17450 of the Seta B <br /> Water COS,or W CONEN to Your perm., aMhcatlun Pursuant to COvarmNent Cocas <br /> Section 66796.00 and Health and Safety COde S.cson 25200. <br />