[SUMMARY OF FINAL SUBMITTED VERSION]


SUPPLEMENTAL STATEMENT OF WATER DIVERSION AND USE FOR REPORTING PERIOD

October 1, 2021 to September 30, 2022
Primary Owner: XARIA THAO
Statement Number: S026139
Date Submitted: 10/22/2022
Water is used under
Riparian Claim
Year diversion commenced 1980
Purpose of Use
Domestic 4 persons
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
0.006138
0.015344
0.006138
November
0.006138
0.015344
0.006138
December
0.006138
0.015344
0.006138
2022
January
0.006138
0.015344
0.006138
February
0.006138
0.015344
0.006138
March
0.006138
0.015344
0.006138
April
0.006138
0.015344
0.006138
May
0.006138
0.015344
0.006138
June
0.006138
0.015344
0.006138
July
0.006138
0.015344
0.006138
August
0.006138
0.015344
0.006138
September
0.006138
0.015344
0.006138
Total
0.073656
0.184128
0.073656
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 (Gallons Per Day)
2021
October 75
November 75
December 75
2022
January 75
February 75
March 75
April 75
May 75
June 75
July 75
August 75
September 75
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
 
Attachments
File Name Description Size
No Attachments
Contact Information of the Person Submitting the Form
First Name Xaria
Last Name Thao
Relation to Water Right Diverter of Record
Contact Information of the Person Submitting the Form
First Name Xaria
Last Name Thao
Relation to Water Right Diverter of Record
Information on Certification and Signatory
Name of Person Signing and Certifying the Report Xaria Thao
Date of Signature 10/22/2022