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SAN J OAQ U I N Environmental Health Department <br /> COUNTY <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: AAA Services Group, Inc. <br /> Facility Address: 26955 Hansen Rd Tracy 95377 <br /> Street City Zip <br /> Facility Business Owner Name: Gurlynn K. Gill Phone: <br /> Property Owner Name: The GF Irrevocable Trust Phone:209-587-3200 <br /> Property Owner Address: 2101 Park Warren Ct. Los Banos 93635 <br /> Street City Zip <br /> WATER PROVISION INFORMATION <br /> 1. Number of houses, mobile homes, or other occupied buildings served by the water well(s):02 <br /> 2. Number of employees at the facility per shift: 02 Number of shifts: 03 <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: <br /> January April July October <br /> February May August November <br /> March June September December <br /> 4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br /> January 210 April 210 July 210 October 210 <br /> February 210 May 210 August 210 November 210 <br /> March 210 June 210 September 210 December 210 <br /> 5. Number of yearlong residents: 03 <br /> 6. Number of residents per month, if variable: <br /> January April 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: Im Date: 09/16/2020 <br /> re <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />