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PA22001o1 SAN J OA Q U I N Environmental Health Department COUN—Y Water Usage Information PROJECT INFORMATION Application Number: A licationT e: Commercial Site Approval/Expansion Project Address: 12941 Blossom Court,Lockeford,CA 95237 Pro ect APN: 051-310-49 and-50 Applicant Name: Highway 88 Self storage,LLC Title: Applicant Address: Po Box 1218 City/Zip: Woodbridge,CA 95258 Applicant Phone: 209-371-8810 Email: RRanchhod@diedeconstruction.com Property Owner Name: Highway 88 Self Storage,LLC Property Owner Address: Po Box 1218 City/Zip: Woodbridge,CA 95258 Property Owner Phone: 209-371-8810 Email: brettdiede@diedeconstruction.com SERVICES INFORMATION Please provide description below: Water Supply: Lockeford CSD ❑ Surface Water(Attach Water Rights Information) Domestic Wastewater Disposal: Process Wastewater Discharge: Ponds: A Iicable WDR: Storm Drainage System: WATER USAGE DATA Provide for total water usage at full buildout Number Persons/Day Gallons/Person/Day Total Gallons/Da Domestic Water Usage by Employees/Customers: 4 1 4 Type of Process/Irrigated Lands Total Gallons/Da Process Water Usage: Process Water Usage: Irrigation Water Usage: Total Gallons Per Day: PROPOSED WELL LOCATION Well Location Address: I Ci Well Location APN: Well Latitude: Well Longitude: Flood Plain Designation: Well Elevation: PROPOSED WELL INFORMATION Well Total De th(ft): Acres to be Served b Well: Use of WeII: ❑ Domestic ❑ Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑ Industrial ❑ Stock ❑ Other: Depth of Corcoran Clay(ft): Proposed Well Capacity (gal/ft): Estimated Pumping Rate (gal/min): —Anticipated Pumping Schedule (gal/day): Estimated Annual Extraction Volume(acre-feet): Estimated Cumulative Extraction Volume before January 1,2020(acre-feet): SITING INFORMATION Distance To Nearest (ft): Onsite: Offsite: Distance To Nearest(ft): Onsite: Offsite: Wastewater Treatment System: Sources of Contamination: Other Wells: Pond/Lake: Sewer Lines: Stream/River: Animal or Fowl Enclosure: Navigable Waterway: Storm Drainage System: Potential Recharge Features: GROUNDWATER INFORMATION Depth ft: Source/Date of Reference: Groundwater Subbasin: Current Depth to Water: ❑ Cosumnes Subbasin(2-22.16) Highest Depth to Water: ❑ Eastern San Joaquin Subbasin(5-22.01) Lowest Depth to Water: ❑Tracy Subbasin(5-22.15) 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sbgov.org/EHD 1 of 2