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SAN JOAQLA Environmev d Health Department <br /> CO�_JNTY PA210 0 2 7 <br /> 5 <br /> Water Usage Information <br /> PROJECT INFORMATION <br /> Application Number: Application Type: Site Approval <br /> Project Address: 7500 W Eleventh St.,Tracy CA Project APN: 250-150-18.250-150-17,250-150-16 <br /> Applicant Name: Edgar Rlzkallah Title: Developer/owner <br /> Applicant Address: 2605 Camino Tassaiara Lane#1582. City/Zip: Danville.CA 94526 <br /> Applicant Phone: 925)548-7910 Email: diamondpetroleuml@yahoo.com <br /> Property Owner Name: Navarra Family,LLC <br /> Property Owner Address: 475 Biewett Rd,Tracy,CA 95304 CIt /ZI : Tracy,CA 95304 <br /> Property Owner Phone: (650)333-5092 Email: Suheil Sahouria<Suheil@TraftonGroup.com, <br /> SERVICES INFORMATION <br /> Please provide description below: One(1)AM PM convenience store and one(1)car wash <br /> Water Supply: Private on-site Well ❑ Surface Water(Attach Water Rights Information) <br /> Domestic Wastewater Disposal: Private Septic on-site system <br /> Process Wastewater Discharge: Ponds: Ap licable WDR: <br /> Storm Drainage System: Underground Storm Water Detention Chamber System and Bioswales <br /> WATER USAGE DATA <br /> Provide for total water usage at full buildout Number Persons/Da Gallons/Person/Da Total Gallons/Da <br /> Domestic Water Usage by Employees/Customers: See C-Store Demand below <br /> Type of Process/Irrigated Lands Total Gallons/Da <br /> Process Water Usage: Convenience Store Demand 36,000 <br /> Process Water Usage: Car Wash Demand 346 <br /> Irrigation Water Usage: N/A N/A <br /> Total Gallons Per Day: 36,346 <br /> PROPOSED WELL LOCATION <br /> Well Location Address: City] <br /> Well Location APN: <br /> Well Latitude: Well Lon itude: <br /> Flood Plain Designation: Well Elevation: <br /> PROPOSED WELL INFORMATION <br /> Well Total De th(ft):1 460 Acres to be Served by Well: <br /> Use of Well: ❑ Domestic ❑ Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock <br /> ❑ Other: <br /> Depth of Corcoran Clay(ft): <br /> Proposed Well Capacity (gal/ft): Estimated Pumping Rate (gal/min): <br /> Anticipated Pumping Schedule (gal/day): Estimated Annual Extraction Volume(acre-feet): <br /> Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): <br /> SITTING INFORMATION <br /> Distance To Nearest(ft): Onsite: Offsite: Distance To Nearest(ft): Onsite: Offsite: <br /> Wastewater Treatment System: 120 135 Sources of Contamination: N/A N/A <br /> Other Wells: N/A 170 Pond/Lake: N/A N/A <br /> Sewer Lines: N/A N/A Stream/River: N/A N/A <br /> Animal or Fowl Enclosure: N/A N/A Navigable Waterway: N/A N/A <br /> Storm Drainage System: N/A N/A Potential Recharge Features: N/A N/A <br /> GROUNDWATER INFORMATION <br /> Depth(ft): Source/Date of Reference: Groundwater Subbasin:5-22.15 <br /> Current Depth to Water: 80,-0" Well Completion Report ❑ Cosumnes Subbasin(2-22.16) <br /> Highest Depth to Water: ❑ Eastern San Joaquin Subbasin(5-22.01) <br /> Lowest Depth to Water: 19 Tracy Subbasin(5-22.15) <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.s'cehd.com <br /> 1 of 2 <br />