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I <br /> SAN J0A0UIN- Environmental Health Department <br /> COUNTY <br /> Greorness grows here. <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 known. <br /> The Environmental Health Department must collect this information before a new well permit is <br /> issued and must post the information on the Department's website for public information. <br /> rf. ',ra- T�RHkSst*" ` <br /> WELL tOGTI©N TANDOVCINE�R�1.:�FO�MT��4� ���� � :��g ; <br /> Well Location Address: o? ,�lEw! TT lQ�, City: in ,0,0A1 f,�f S'.736. 96 Y <br /> Well Location APN: �7_0.2p_o-�p _p®a <br /> Well Latitude: 37. 9-7 5-4f Well Longitude: _1;X A -O 3886 0 <br /> Flood Plain Designation: Well Elevation-.1 !!8 <br /> Applicant Name: j-, „rs 1,ve- �A4MnV, !+Applicant Title: i2iSeDen�! <br /> Applicant Address: ! c/3 d-vC 57-/4 C Y. City: ljv,vo,2,d &L 411-37o <br /> Applicant Phone: 00`7J Sr3 _ 91 3(o Applicant email: 35vNs D,Pieer s ,saa�c C®°�' <br /> Property Owner Name: lgsb„t of LLE <br /> Property Owner Address: 15 .lyet�a TT 2d City: b,Nv fid <br /> Property Owner Phone: o 77o Property Owner email: <br /> PROPOSED WELL INFORMATION - 0 f x Fir <br /> Well Total Depth(ft):1 I Acres to be Served by Well: <br /> Use of Well: ❑ Domestic ❑Irrigation ❑Small Public Water Supply ❑ Municipal Public Water Supply ❑In stria) [I Stock <br /> ❑Other: ST . bol zJE ?7 G t( ALL <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 /> Total Number of Existing Wells on Property: A <br /> Please complete the information below for every well on property. Use extra paper if needed <br /> Well#1 Information <br /> Use of Well: Domestic ❑ Irrigation ❑Small Public Water Supply ❑Municipal Public Water Supply ❑ Industrial ❑Stock <br /> ❑Other: <br /> 175- Total Depth(ft): '((6 4V/P,5 To: From: <br /> R 10" Casing Diameter(in): 4.5" ❑Open Bottom or Screen Interval(ft): To: From: <br /> Pumping Rate(gpm):,ze - 3e, To: From: <br /> Annual Extraction Volume(acre-feet: 1i(,+f A Estimated ❑ Measured <br /> Specific Capacity(gallmin/ft): 30 1,007 <br /> Other Pumping Tests Performed:1 ,v o A A Test Result: <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 1 T 209 468-3420 1 IF 209 464-0138 1 www.sjcehd.com <br />