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SAN OAOUIN --COU f'JTY-- <br />Water Usage Information <br />PROJECT INEORMATION <br />p <br />Pleas <br />□Surface Water (Attach Water Rights Information) <br />- <br />Domestic Wastewater Disposal: <br />Process Wastewater Discharge: Ponds: A licable WDR: <br />Total -Gallons/Da <br />-. - <br />Well Location Address: <br />Well Location APN: <br />Well Latitude: <br />Flood Plain Desiqnation: <br />•-•. '� .. :---· - <br />Well Total Depth (ft) :I <br />Irrigation Water Usage: <br />- <br />. <br />-. <br />I <br />,, PROPOSEDWELLLOCATION <br />Total GallonsPeroa···; <br />.- <br />-- <br />----- <br />,;-../.L Sri', u:. .. I City:I <br />I Well Longitude:! <br />Well Elevation:! <br />·PROP<lSEDWELL INFORMATmN --- <br />-- --. <br />Acres to be Served by Well:! <br />- <br />.· -- <br />-- <br />Use of Well: □Domestic □ Irrigation □Small Public Water Supply □ Municipal Public Water Supply □ Industrial <br />D Other: <br />Depth of Corcoran Clay ft): <br />Proposed Well Capacity (qal/ft): <br />Anticipated Pumpinq Schedule (gal/day): <br />---•--. <br />--Distance To Nearest (ft): <br />Wastewater Treatment System: <br />---- <br />other Wells: <br />Sewer Lines: <br />Animal or Fowl Enclosure: <br />Storm Drainaqe System: <br />·--.. --, ., <br />Onsite: <br />-- <br />Estimated Pumping Rate (qal/min': <br />Estimated Annual Extraction Volume (acre-feet : <br />Estimated Cumulative Extraction Volume before January 1-, 2020 (acre-feet : <br />•-'- <br />- <br />_---·smNG INFORMATION·-.. ---·•Offsite: Distance To Nearest (ft): <br />Sources of Contamination: <br />Pond/Lake: <br />Stream/River: <br />Naviqable Waterway: <br />Potential Recharqe Features: <br />GROUNOWATERINFORMATION--• ---. > <br />---Onsite: <br />·-. <br />_- <br />- <br />Depth (ft): Source/Date of Reference: Groundwater Subbasin: <br />- <br />-- <br />□Stock <br />-- <br />Offsite: <br />Current Depth to Water: □Cosumnes Subbasin (2-22.16) <br />- <br />Highest Depth to Water: D Eastern San Joaquin Subbasin (5-22.01) <br />Lowest Depth to Water: D Tracy Subbasin (5-22.15) <br />1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sicehd.com <br />1 of 2 <br />- <br />ronme <br />Pro' ect Address: Z, <br />Title: <br />pp <br />II buildout <br />.