[SUMMARY OF FINAL SUBMITTED VERSION]

SUPPLEMENTAL STATEMENT OF WATER DIVERSION AND USE FOR REPORTING PERIOD

Primary Owner: MARALEE HINMAN
Statement Number: S021670

Water is used under	Riparian Claim
Year diversion commenced	1990

Purpose of Use
Domestic	2hshlds-2-3 persons no garden

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 beneficially 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	0.002762	0.003683	0.002762
May	0.002762	0	0.002762
June	0.002762	0	0.002762
July	0.002762	0	0.002762
August	0.002762	0	0.002762
September	0.002762	0	0.002762
Total	0.016572	0.003683	0.016572
Type of Diversion	Both Direct Diversion and Diversion to Storage
Comments

Water Diversion Measurement
Required to measure as of the date this report is submitted	No
Is diversion measured?	No
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 Attachments
Measurement ID Number	File Name	Description	Size
No attachments

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

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

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
From Oct 1 2021 through March 2022, water was delivered and no diversion. April 2022 pumping began pumping 1200 gallons to storage in case hayfork creak dried up again. Was not used. Still sitting in tank. No more to storage after that.

Attachments
File Name	Description	Size
No Attachments

Contact Information of the Person Submitting the Form
First Name	Michael
Last Name	Aoun
Relation to Water Right	Other: SWRCB Employee with permission from Maralee Hinman

Contact Information of the Person Submitting the Form
First Name	Michael
Last Name	Aoun
Relation to Water Right	Other: SWRCB Employee with permission from Maralee Hinman

Information on Certification and Signatory
Name of Person Signing and Certifying the Report	Michael Aoun
Date of Signature	01/23/2023