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ou:"T, SAKJ0A0UIN <br />ui I%& COUNTY— <br />Greatness grows here. <br />EnvironmentalHealth Department <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 <br />known. The Environmental Health Department must collect this information before a new well <br />permit is issued and must post the information on the Department's website for public information. <br />PRQF=,ED-*RU b V <br />well Total Depth (ft):j I qo6, <br />40'15 - <br />Acres to be Served by Well: Fi:-7.Z So <br />Well Location Address: t <br />I City: <br />Well Location APN: 6 q4 <br />Well Latitude: <br />Well Longitude: <br />Estimated Pumping Rate (gal/min): goo <br />Flood Plain Designation:, <br />Well Elevation: <br />I Estimated Annual Extraction Volume (acre-feet): I-ess 114,WN z <br />Estimated Cumulative Extraction Volume before January 1, 2020 (acre-feet): /-ew s ?*-k vq <br />Applicant Name: <br />Applicant Title: 1 <br />Applicant Address: p, c, pw z 0 <br />city <br />Applicant Phone: <br />,q 44 <br />Applicant email <br />Property Owner Name: <br />0 Other. <br />W-0 <br />Property Owner Address: <br />City] <br />Total Depth (ft): <br />Property Owner Phone: <br />Property Owner email:1 <br />From: <br />From: <br />From: <br />PRQF=,ED-*RU b V <br />well Total Depth (ft):j I qo6, <br />40'15 - <br />Acres to be Served by Well: Fi:-7.Z So <br />Use of Well: <br />ci Domestic X Irrigation 0 Small Public Water Supply 0 Municipal Public Water Supply 0 Industrial 0 Stock <br />0 Other. <br />Depth of Corcoran Clay (ft): <br />Proposed Well Capacity (gal/ft): <br />to&,ivy <br />Estimated Pumping Rate (gal/min): goo <br />Anticipated Pumping Schedule (gal/day): <br />- IA. , <br />I Estimated Annual Extraction Volume (acre-feet): I-ess 114,WN z <br />Estimated Cumulative Extraction Volume before January 1, 2020 (acre-feet): /-ew s ?*-k vq <br />a <br />M -XI <br />-- <br />Total Number of Existing Web on Property, <br />a — <br />Please complete the information below for every well on property. Use extra paper if needed <br />Well #1 Information <br />0 Domestic 0 Irrigation <br />o Small Public Water Supply 0 Municipal Public Water Supply <br />u1ndustrial 0 Stock <br />Use of Well: <br />0 Other. <br />Total Depth (ft): <br />To: <br />0 Open Bottom or Screen Interval (ft): To: <br />To: <br />From: <br />From: <br />From: <br />Casing Diameter (in): <br />Pumping Rate (gpm): <br />Annual Extraction Volume (acre-feet <br />0 Estimated 0 Measured <br />----7-- <br />Specific Capacity (gal/minft <br />Other Pumping Tests Performed: <br />Test Res, <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />