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SAN',,JOAQUIN �.:—COUNTY— U, -eUtress grows here. Environmental Health Department Well Information Pursuant to California Water Cod, ection 13808, all new wells that do not meet the exemption criteria must submit the following required information, to the extent that can be reasonably known. The Environmental Health Departm nt must collect this information before a new well permit is issued and must post the informatio on the Department's website for public information. WELD:'0 O fi�.10- E I Well Location Address: OX Al. S S I City: j q5Z,4ZO Well Location APN: (O ❑ SmE II Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock Well Latitude: yJ01 Well Longitude. -F-720. 99993 Flood Plain Designation: Anticipated Pumping Schedule (gaVday): Well Elevation: Pumping Rate (gpm): i Estjm ted Cumulative Extraction Volume before January 1, 2020 (acre-feet): s Estimated ❑ Measured Applicant Name: Can pa and Sons, Ir c Applicant Title: Contractor Applicant Address: 14384 Cuesta Court City: Sonora Applicant Phone: (209) 532-1136 Applicant email: csonsdrilling@gmail.com Property Owner Name: o SLC Property Owner Address: �j City: S�j Property Owner Phone: Property Owner email: M,1 m'�'r't] i Alx� as to .+wa akJ s:..Y�.S�v'e�5,"�'i-� Well Total Depth (ft): 00 i Acres to be Served by Well:1 VO Use of Well: ❑ Domestic XImigation ❑ Other: ❑ SmE II Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock Depth of Corcoran Clay (ft): yJ01 Proposed Well Capacity (gallft): 4-1160q Estimated Pumping Rate (gallmin): 250 Anticipated Pumping Schedule (gaVday): /.Z ►�4t]N-i Zd6t Estimated Annual Extraction Volume (acre-feet): 9S Pumping Rate (gpm): i Estjm ted Cumulative Extraction Volume before January 1, 2020 (acre-feet): s m'�'r't] i Alx� as to .+wa akJ s:..Y�.S�v'e�5,"�'i-� Total Number of Existing Wells on Property, Please complete the information below for every well on property. Use extra paper if needed Well #1 Information(( D Use of Well: l" Domestic ❑ Irrigation El Sr all Public Water Supply ❑ Municipal Public Water Supply ❑ Other: ElIndustrial ClStock Total Depth (ft): Q(J To: ❑ Open Bottom or Screen Interval (ft): To: To: From: From: From: Casing Diameter (in): S Pumping Rate (gpm): i Annual Extraction Volume (acre-feet: h 2_� Estimated ❑ Measured Specific Capacity (gaVmin/ft): j Other Pumping Tests Performed: Test Result: 1868 E. Hazelton Avenue 1 Stockton, Califom a 95205 I T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com 1