[SUMMARY OF FINAL SUBMITTED VERSION]


SUPPLEMENTAL STATEMENT OF WATER DIVERSION AND USE FOR 2011

Primary Owner: MARALEE HINMAN
Statement Number: S011200
Date Submitted: 06/27/2014
1. Water is used under
Riparian Claim
2. Year of first use 1976
3-4. Maximum Rate of Diversion for each Month and Amount of Water Diverted and Used
Month Rate of diversion
(GPD)
Amount directly diverted or
collected to storage
(Gallons)
Amount beneficially used
(Gallons)
January 0 0 0
February 0 0 0
March 0 0 0
April 0 0 0
May 0 0 0
June 0 0 0
July 0 0 0
August 0 0 0
September    0 0 0
October 0 0 0
November 0 0 0
December 0 0 0
Total 0 0
Comments This property was purchased by William and Maralee Hinman in Oct. 2010.It is a rental and the 2011 tenant did not use surface water from Hayfork creek
5. Water Diversion Measurement
a. Measurement
b. Types of measuring devices used
c. Additional technology used
Description of additional technology used
d. Who installed your measuring device(s)
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"
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
Explanation of method(s) used as an alternative to direct measurement
6. Purpose of Use
Other N/A
7. Changes in Method of Diversion
Surface water pump not used by tenant in2011 
8. Conservation of Water
a. Are you now employing water conservation efforts?
Describe any water conservation efforts you have initiated
b. Amount of water conserved Acre-Feet
I have data to support the above surface water use reductions due to conservation efforts. No
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?
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 Yes
10. Conjuctive Use of Surface Water and Groundwater
a. Are you now using groundwater in lieu of surface water? Yes
b. Amount of groundwater used 400 Gallons
I have data to support the above surface water use reductions due to the use of groundwater. Yes
11a. Additional Remarks
Well installed on property in 1986.Have supporting documentation.Will submit copies if required. Change of ownership. Property is rental.Well is domestic,and for small garden.No surface water used under this Statement in 2011. 
Attachments
File Name Description Size
No Attachments
Contact Information of the Person Submitting the Form
First Name Maralee
Last Name Hinman
Relation to Water Right New Diverter of Record
The information in the report is true to the best of his/her knowledge and belief Yes