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SAN JOA 0 u f N Environmental Health Department <br /> WATER PROVISION DECLARATION <br /> Facility Business Name Griffith Energy Storage Project <br /> Facility Address: 17775 Midway Road, Tracy, CAS 95377 <br /> Sheri CITY Zp <br /> Facility Business Owner Name Griffith Energy Storage, LAG Prione: 206-265-0278 <br /> Property Owner Name: Griffith Family Properties, LLC Phone: 209-610-7616 <br /> Property Owner Address: 20044 Midway Road <br /> Set✓&, c1tY Zip <br /> WATER PROVISION INFORMATION <br /> I Number of houses,mobile homes,or other occupied buildings served by the water well(s).� <br /> 2. Number of employees at the facility per shift: Number of shifts: <br /> 3. Total number of employees,customers,and visitors at the facility per month,if variable: <br /> January G April n July jo WOW o <br /> February c May 0 August o November o <br /> Match n June 0 September 10 December 0 <br /> 4. Number of days that total number of customers,visitors and employees frequent the facility per month: <br /> January NIA April NIA Jury PJA Oclobar fiA <br /> February trlA May WA August I P. November rvA <br /> March NjA June NIA septem6er ;r-oA ❑ecemuer NIA <br /> 5. Number of yearlong residents: 0 <br /> 6. Number of residents per month, it variable: <br /> January o April 0 July io October a <br /> February o May n Auguai to November n <br /> March o June D September qo December lo <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 it the water provision information of the facility changes. <br /> Facility Business/Property Owner: Date; <br /> Ipnause <br /> IASA F 11,3nm in Avco IA I StnGkton t.akrnrrnla q5209 I T 261,1 4618-34?rl F IIIA en 01:4A ( Ww.v slreh(lrno) <br />