[SUMMARY OF FINAL SUBMITTED VERSION]

REPORT OF LICENSEE FOR REPORTING PERIOD

Primary Owner: PETER DESSAU
Primary Contact:

Application Number: A009173
License Number: 002550

Source(s) of Water	POD Parcel Number	County
HAYFORK CREEK	011-280-48	Trinity

MAX Direct Diversion Rate: 0.55 CFS
MAX Collection to Storage: 0 AC-FT
Face Value: 166.9 AC-FT

Permitted Use(s)	Acres	Direct Diversion Season	Storage Season
Irrigation	25	05/01 to 09/30

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
Irrigation

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)
2022
October	0	0	0
November	0	0	0
December	0	0	0
2023
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	0.00214	0	0.00214
September	0	0	0
Total	0.00214	0	0.00214
Type of Diversion	Direct Diversion Only
Comments	Given low water flows in Hayfork Creek, we desired to minimize use to promote ecological development.

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 number	M035229
This Device/Method was used to measure water during the current reporting period	Yes
Briefly describe the measurement device or method	A tank was filled and the tank was 250 gallons; the capacity is the method of measurement.
Nickname
Type of device / method
Device make
Serial number
Model number
Approximate date of installation	07/01/2022
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	No
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
No data files

Maximum Rate of Diversion
Month	Rate of Diversion (Gallons Per Minute)
2022
October	0
November	0
December	0
2023
January	0
February	0
March	0
April	0
May	0
June	0
July	0
August	20
September	0

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 2023
Amount (Acre-Feet) projected for 2024
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
2022
October
November
December
2023
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	peter
Last Name	dessau
Relation to Water Right	Primary Owner of Record

Information on Certification and Signatory
Name of Person Signing and Certifying the Report	peter dessau
Date of Signature	01/13/2024