Statement Number: S019572
Date Submitted: 02/06/2013
1. Water is used under
Riparian Claim
2. Year of first use 1946
3-4. Maximum Rate of Diversion for each Month and Amount of Water Diverted and Used
Month Rate of diversion
Amount directly diverted or
collected to storage
Amount beneficially used
January 0 0 0
February 0 0 0
March 300 0.00092067 0.00092067
April 900 0.00276201 0.00276201
May 1500 0.00460335 0.00460335
June 3000 0.0092067 0.0092067
July 3000 0.0092067 0.0092067
August 3000 0.01074115 0.0092067
September    3000 0.0092067 0.0092067
October 900 0.00460335 0.00460335
November 0 0 0.00092067
December 0 0 0
Total 0.05125063 0.05063685
5. Water Diversion Measurement
a. Measurement
Water directly diverted and/or diverted to storage was measured
b. Types of measuring devices used
  • Other: storage tank
c. Additional technology used
  • Other
Description of additional technology used Capacity of storage tank
d. Who installed your measuring device(s)
  • Other: Self
e. Make, model number, and last calibration date of your measuring device(s)
f. Why direct measurement using a device listed in Section 1 is "not locally cost effective"
  • Diversion is small or minimal in size
Explanation of why use of devices and technologies listed in Section 1 are "not locally cost effective"
g. Method(s) used as an alternative to direct measurement
  • Crop duty estimates/consumptive use estimates
Explanation of method(s) used as an alternative to direct measurement
6. Purpose of Use
Domestic 0
Irrigation 4.60 Acres
Stockwatering 0
Other 0
7. Changes in Method of Diversion
8. Conservation of Water
a. Are you now employing water conservation efforts? Yes
Describe any water conservation efforts you have initiated Drip Irrigation
b. Amount of water conserved Acre-Feet
I have data to support the above surface water use reductions due to conservation efforts.
9. Water Quality and Wastewater Reclamation
a. Are you now or have you been using reclaimed water from a wastewater treatment facility, desalination facility, or water polluted by waste to a degree which unreasonably affects such water for other beneficial causes? No
b. Amount of reduced diversion
Type of substitute water supply
Amount of substitute water supply used
I have data to support the above surface water use reductions due to the use of a substitute water supply
10. Conjuctive Use of Surface Water and Groundwater
a. Are you now using groundwater in lieu of surface water? No
b. Amount of groundwater used
I have data to support the above surface water use reductions due to the use of groundwater.
11a. Additional Remarks
File Name Description Size
No Attachments
Contact Information of the Person Submitting the Form
First Name Vincent
Last Name Johnson
Relation to Water Right Owner
Has read the form and agrees the information in the report is true to the best of his/her knowledge and belief Yes