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SAN 10AQ U I N Environmental Health Department <br /> --C-O U N T Y -- <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: Zinc House Winery <br /> Facility Address: 20679 E. Hwy 120, Escalon CA 95320 <br /> Street City Zip <br /> Facility Business Owner Name: Latitude 37 Partners, LLC Phone: 209-595-8348 <br /> Property Owner Name: John and Mary Lynne Franzia Family Trust Phone: 209-838-3054 <br /> Property Owner Address: 20100 Zumwalt Rd. Escalon CA 95320 <br /> Street City Zip <br /> MTER PROVISION INFORMATION <br /> 1. Number of houses, mobile homes, or other occupied buildings served by the water well(s):3 <br /> 2. Number of employees at the facility per shift: 20 Number of shifts: 1 <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: <br /> January 5 1 April 10 July 20 October 10 <br /> February 5 1 May 120 August 20 November 10 <br /> March 5 1 June 120 September 20 December 5 <br /> 4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br /> January 45 April 110 July 220 October 110 <br /> February 85 May 120 August 220 November 90 <br /> March 85 June 220 September 220 December 45 <br /> 5. Number of yearlong residents: 0 <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 /> 1 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: Date: "/ l"b Z"L' <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 />