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SHARON <br />COUNTY <br />Greatness grows here. <br />Environmental Health Department <br />WATER PROVISION DECLARATION <br />Facility Business Name: Central Valley Concrete, Inc. <br />Facility Address: 37400 S. Bird Road, Tracy, CA <br />Facility Business Owner Name: Scott Neal <br />Property Owner Name: Granite Construction Company <br />Property Owner Address: 4001 Bradshaw Road, Sacramento, CA 95827 <br />Street <br />WATER PROVISION INFORMATION <br />city <br />Phone: <br />Phone: (916) 855-4400 <br />1. Number of houses, mobile homes, or other occupied buildings served by the water well(s): 0 <br />2. Number of employees at the facility per shift: 6 MaX Number of shifts: 1 TyplCal <br />The total employee count includes between 1 and 2 employees on site for operating the concrete batch plant and between 3 to 5 transient <br />truck drivers, with a maximum combined total of 6 employees at anytime. _ <br />3. Total number of employees, customers, and visitors at the facility per month, if variable: <br />January 1 1 April 1 5 1 6 October 4 <br />February 4 May 6 August 6 November 4 <br />March 5 June 6 September 6 December 1 <br />Number of employees per month will depend on sales, which are market and weather -driven. <br />4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br />January 4 April 10 July 20 October 10 <br />February 8 May 14 August 20 November 8 <br />March 8 June 20 September 20 December 4 <br />5. Number of yearlong residents: _0 <br />6. Number of residents per month, if variable: <br />January Aprii July October <br />February May August November <br />March June September December <br />I declare under penalty of perjury that the statements on this application are correct to my knowledge. It is the <br />owner's responsibility to notify this office if the water provision information of the facility changes. <br />Facility Business/Property Owner: z/ Date: <br />Signature <br />1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />