[SUMMARY OF FINAL SUBMITTED VERSION]


SUPPLEMENTAL STATEMENT OF WATER DIVERSION AND USE FOR 2020

Primary Owner: GENE C. GRAVES
Statement Number: S021705
Date Submitted: 05/25/2021
1. Water is used under
Riparian Claim
Other: Grant Deed gives a 1/6 interest in and to any water rights
2. Year diversion commenced 1969
2. Purpose of Use
No Use
3. Special Use Categories
C1. Are you using any water diverted under this right for the cultivation of cannabis? No
4. 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 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 0
Type of Diversion No Diversion
Comments 2020 was a dry year, Hayfork Creek is running dry in the summer. Will not be using in 2021 because of the drought.
5. 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
6. Maximum Rate of Diversion
Month Rate of Diversion (Gallons Per Minute)
January 0
February 0
March 0
April 0
May 0
June 0
July 0
August 0
September 0
October 0
November 0
December 0
7. Water Transfers
8a. Water transfered No
8b. Quantity transfered (Acre-Feet)
8c. Dates which transfer occurred / to /
8d. Transfer approved by
Water Supply Contracts
8e. Water supply contract No
8f. Contract with
8g. Other provider
8h. Contract number
8i. Source from which contract water was diverted
8j. Point of diversion same as identified water right
8k. Amount (Acre-Feet) authorized to divert under this contract
8l. Amount (Acre-Feet) authorized to be diverted in 2020
8m. Amount (Acre-Feet) projected for 2021
8n. Exchange or settlement of prior rights
8o. All monthly reported diversion claimed under the prior rights
8p. Amount (Acre-Feet) of reported diversion solely under contract
Credits Claimed
Conservation Reclaimed Water Use Conjunctive Groundwater Use
Claimed? (Yes/No) No No No
January
February
March
April
May
June
July
August
September
October
November
December
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
We have had a drought for several years. The water in Hayfork Creek is very low and probably will be worst in 2021. Until the water in Hayfork Creek gets higher, I wil not be diverting water. 
Attachments
File Name Description Size
No Attachments
Contact Information of the Person Submitting the Form
First Name Gene
Last Name Graves
Relation to Water Right Diverter of Record
The information in the report is true to the best of his/her knowledge and belief Yes
Contact Information of the Person Submitting the Form
First Name Gene
Last Name Graves
Relation to Water Right Diverter of Record
Information on Certification and Signatory
Name of Person Signing and Certifying the Report Gene Graves
Date of Signature 05/25/2021