[SUMMARY OF FINAL SUBMITTED VERSION]

SUPPLEMENTAL STATEMENT OF WATER DIVERSION AND USE FOR 2014

Primary Owner: LEWIS EVANS
Statement Number: S010138

1. Water is used under	Riparian Claim Pre-1914 Claim Other: ditch bill act
2. Year diversion commenced	1913

3. Purpose of Use
Fire Protection	hume lake
Dust Control	roads
Incidental Power	7.50 kW
Power	75 kW

4. Changes in Method of Diversion

Special Use Categories
C1. Are you using any water diverted under this right for the cultivation of cannabis?	No

5. Maximum Rate of Diversion
Month	Rate of Diversion (Gallons Per Minute)
January	0
February	0
March	0
April	150
May	150
June	150
July	150
August	150
September	150
October	150
November	0
December	0

6. Amount of Water Diverted and Used
Month	Amount directly diverted (Acre-Feet)	Amount diverted or collected to storage (Acre-Feet)	Amount beneficially used (Acre-Feet)
January	0	0	0
February	0	0	0
March	0	0	0
April	150	0	150
May	150	0	150
June	150	0	150
July	150	0	150
August	150	0	150
September	150	0	150
October	150	0	150
November	0	0	0
December	0	0	0
Total	1050	0	1050
Type of Diversion	Direct Diversion Only
Comments

Water Transfers
6d. Water transfered	No
6e. Quantity transfered (Acre-Feet)
6f. Dates which transfer occurred	/ to /
6g. Transfer approved by

Water Supply Contracts
6h. Water supply contract	No
6i. Contract with
6j. Other provider
6k. Contract number
6l. Source from which contract water was diverted
6m. Point of diversion same as identified water right
6n. Amount (Acre-Feet) authorized to divert under this contract
6o. Amount (Acre-Feet) authorized to be diverted in 2014
6p. Amount (Acre-Feet) projected for 2015
6q. Exchange or settlement of prior rights
6r. All monthly reported diversion claimed under the prior rights
6s. Amount (Acre-Feet) of reported diversion solely under contract

7. Water Diversion Measurement
a. Required to measure as of the date this report is submitted	No
b. Is diversion measured?	No
c. An alternative compliance plan was submitted to the division of water rights on
d. A request for additional time was submitted to the division of water rights on

Measurement Attachments
Measurement ID Number	File Name	Description	Size
No attachments

Measurement Data Files
Measurement ID Number	File Name	Description	Size
No data files

8. Conservation of Water
a.	Are you now employing water conservation efforts?	No
	Describe any water conservation efforts you have initiated
b.	Amount of water conserved
	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.

Additional Remarks

Attachments
File Name	Description	Size
No Attachments

Contact Information of the Person Submitting the Form
First Name	lewis
Last Name	evans
Relation to Water Right	Diverter of Record
The information in the report is true to the best of his/her knowledge and belief	Yes