[SUMMARY OF FINAL SUBMITTED VERSION]


REPORT OF LICENSEE FOR REPORTING PERIOD

October 1, 2021 to September 30, 2022

Primary Owner: OSTROM FAMILY TRUST
Primary Contact:

Date Submitted: 01/30/2023

Application Number: A011501
License Number: 003393

Source(s) of Water POD Parcel Number County
ANDERSON SPRING 008-120-009, Sierra

MAX Direct Diversion Rate: 0.125 CFS
MAX Collection to Storage: 0 AC-FT
Face Value: 38.2 AC-FT

Permitted Use(s) Acres Direct Diversion Season Storage Season
Domestic 0 05/01 to 10/01
Compliance with License Terms and Conditions
I have currently reviewed my water right license and I am complying with all terms and conditions Yes
Description of noncompliance with terms and conditions
Changes to the Project
Intake location has been changed
Description of intake location changes
Type of use has changed
Description of type of use changes
Place of use has changed
Description of place of use changes
Other changes
Description of other changes
Purpose of Use
Domestic 125 connections
Fire Protection tank storage
Special Use Categories
Are you using any water diverted under this right for the cultivation of cannabis? No
Amount of Water Diverted and Used
Month Amount directly diverted
(Acre-Feet)
Amount diverted or collected to storage
(Acre-Feet)
Amount used
(Acre-Feet)
2021
October
0
0
0
November
0
0
0
December
0
0
0
2022
January
0
0
0
February
0
0
0
March
0
0
0
April
0
0
0
May
2.67
0
2.67
June
2.51
0
2.51
July
2.36
0
2.36
August
3.25
0
3.25
September
1.42
0
1.42
Total
12.21
0
12.21
Type of Diversion Direct Diversion Only
Comments
Water Diversion Measurement
Required to measure as of the date this report is submitted Yes
Is diversion measured? Yes
An alternative compliance plan was submitted to the division of water rights on
A request for additional time was submitted to the division of water rights on
Measurement ID numberM020552
This Device/Method was used to measure water during the current reporting periodYes
Briefly describe the measurement device or method
Nickname
Type of device / method
Device make
Serial number
Model number
Approximate date of installation
Additional info
Approximate date the measuring device was last calibrated or the measurement method was updated
Estimated accuracy of measurement
Description of calibration method
Describe the maintenance schedule for the device/method
Information for the person who last calibrated the device or designed the measurement method
Name
Phone number
Email
Qualifications of the individual
License number and type for the qualified individual above and/or any other relevant explanation
Type of data recorder device / method
Data recorder device make
Data recorder serial number
Data recorder model number
Data recorder units of measurement
Frequency of data recording
Additional data recorder info
I am required to report my diversion or storage data by telemetry as of the date this report is submitted
I report my diversion or storage date by telemetry to the following website
Measurement Attachments
Measurement ID Number File Name Description Size
No attachments
Measurement Data Files
Measurement ID Number File Name Description Size
M020552 RR Lewis_Anderson Spring_2021-22 Diversion Data_HAS.xlsx 18 KB
Maximum Rate of Diversion
Month Rate of Diversion
2021
October
November
December
2022
January
February
March
April
May
June
July
August
September
Water Transfers
Water transfered No
Quantity transfered (Acre-Feet)
Dates which transfer occurred / to /
Transfer approved by
Water Supply Contracts
Water supply contract No
Contract with
Contract number
Source from which contract water was diverted
Point of diversion same as identified water right
Amount (Acre-Feet) authorized to divert under this contract
Amount (Acre-Feet) authorized to be diverted in 2022
Amount (Acre-Feet) projected for 2023
Exchange or settlement of prior rights
All monthly reported diversion claimed under the prior rights
Amount (Acre-Feet) of reported diversion solely under contract
Storage
Reservoir name Spilled this year Feet below spillway at maximum storage Completely emptied Feet below spillway at minimum storage Method used to measure water level
           
Credits Claimed
Conservation Reclaimed Water Use Conjunctive Groundwater Use
Claimed? (Yes/No) No No No
2021
October
November
December
2022
January
February
March
April
May
June
July
August
September
Conservation Supporting Information
Description of conservation methods
Description of baseline water use and time period
Description of conservation calculation methods
Conserved water used?
Additional Remarks
 
Attachments
File Name Description Size
No Attachments
Contact Information of the Person Submitting the Form
First Name Jennifer
Last Name Spaletta
Relation to Water Right Attorney
Information on Certification and Signatory
Name of Person Signing and Certifying the Report Jennifer Spaletta
Date of Signature 01/30/2023