[SUMMARY OF FINAL SUBMITTED VERSION]

REPORT OF LICENSEE FOR 2017

Primary Owner: RICHARD MARSHALL HIX
Primary Contact:

Application Number: A022832
Permit Number: 015726

Source(s) of Water	POD Parcel Number	County
SIMMS CREEK		Trinity

MAX Direct Diversion Rate: 0.84 CFS
MAX Collection to Storage: 2.5 AC-FT
Face Value: 302 AC-FT

Permitted Use(s)	Acres	Direct Diversion Season	Storage Season
Irrigation	32	05/01 to 10/31	10/01 to 06/01
Stockwatering	0	01/01 to 12/31	10/01 to 06/01
Domestic	0	01/01 to 12/31	10/01 to 06/01

1. Project Abandoned
The project has been abandoned and I request revocation of my water right license	No

2. 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

3. 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

4. Purpose of Use
Domestic	4 full-time persons; 1-ac garden
Irrigation
Stockwatering	cattle

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

5. Maximum Rate of Diversion for each Month
Month	Maximum Rate of Diversion (GPM)
January	15
February	15
March	15
April	15
May	15
June	15
July	15
August	15
September	11
October	11
November	11
December	0

6. Amount of Water Diverted and Used
Month	Amount directly diverted (Acre-Feet)	Amount diverted or collected to storage (Acre-Feet)	Amount used (Acre-Feet)
January	0.09	0	0.09
February	0.08	0	0.08
March	0.09	0	0.09
April	0.09	0	0.09
May	0.75	0	0.75
June	1.75	0	1.75
July	2.08	0	2.08
August	2.08	0	2.08
September	1.03	0	1.03
October	1.06	0	1.06
November	1.03	0	1.03
December	0	0	0
Total	10.13	0	10.13
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 2017
6p. Amount (Acre-Feet) projected for 2018
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	Yes
b. Is diversion measured?	Yes
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 ID number	M007470
This Device/Method was used to measure water during the current reporting period	Yes
M1. Briefly describe the measurement device or method	1.5" Positive-displacement device
M2. Nickname	Sims Creek Meter
M3. Type of device / method	Flow meter (positive displacement)
M4. Device make	EKM Metering Inc.
M5. Serial number	2016 S/N00000299
M6. Model number	EKM-SPWM-150-CF
M7. Approximate date of installation	08/31/2017
M8. Additional info
M9. Approximate date the measuring device was last calibrated or the measurement method was updated	01/01/2016
M10. Estimated accuracy of measurement	2 - 5%; flow dependent
M11. Description of calibration method	Test report not available from EKM. Owner will flow through meter into a calibrated drum within the range of diversion flow rates in order to develop a calibration chart.
M12. Describe the maintenance schedule for the device/method	Owner will use the American Water Works Association recommended 5-yr test frequency for 1.5" positive displacement meters.
Information for the person who last calibrated the device or designed the measurement method
M13. Name	Richard Hix
M14. Phone number	510-529-1403
M15. Email	marshall.xih@gmail.com
M16. Qualifications of the individual	Person trained and experienced in water measurement (for diversions of less than 100 acre-feet per year - no specific training is required; the person using any equipment and reporting the information must know how to use the equipment and submit correct information)
M17. License number and type for the qualified individual above and/or any other relevant explanation	Owner will provide future calibrations. He is a PhD Chemical Engineer with 25+years experience in research and industrial flow measurement.
M18. Type of data recorder device / method	Data logger (digital)
M19. Data recorder device make	Onset Computer Corp.
M20. Data recorder serial number	20197823
M21. Data recorder model number	H21-USB
M22. Data recorder units of measurement	Acre-Feet
M23. Frequency of data recording	Hourly
M24. Additional data recorder info	Device counts meter pulses and outputs total pulse count for the time selected, hourly, time period. One pulse = 0.1 ft3. Logger installed 02/13/2018. 2017 metered diversion data was by manually recorded meter readings.
M25. I am required to report my diversion or storage data by telemetry as of the date this report is submitted	No
M26. I report my diversion or storage date by telemetry to the following website
M27. I have attached additional information on the method I used to calculate the volume of water	Yes
M28. Describe any documents related to this measurement device or method that are attached to this water use report	spreadsheet comparing data logger output vs. meter readings.

8. 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
Sims Creek Pond	No	15	Yes		visual estimate

Conservation of Water
9. Are you now employing water conservation efforts?	Yes
Description of water conservation efforts	Did not use pond in 2017 due to inability to meet current measurement requirements. Owner plans to install either staff gauges or a ditch-intake weir for flow measurements in 2018. Pond seepage is not negligible, therefore owner is considering installation of a pond liner and fencing to protect liner from cattle. Cost and time availability are issues.
10. Amount of water conserved

Water Quality and Wastewater Reclamation
11. During the period covered by this Report, did you use reclaimed water from a wastewater treatment facility, water from a desalination facility, or water polluted by waste to a degree which unreasonably affects the water for other beneficial uses?	No
12. Amount of reclaimed, desalinated, or polluted water used

Conjuctive Use of Groundwater and Surface Water
13. During the period covered by this Report, were you using groundwater in lieu of available surface water authorized under your license?	No
14. Amounts of groundwater used

Additional Remarks
System only allowed me to attach one file.

Attachments
File Name	Description	Size
2018Mar14 Sims Creek Meter Data.xlsx	Meter volume and data logger comparison	13 KB

Contact Information of the Person Submitting the Form
First Name	Richard
Last Name	Hix
Relation to Water Right	Primary Owner of Record

Information on Certification and Signatory
Name of Person Signing and Certifying the Report	Richard Hix
Date of Signature	03/21/2018