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SU0015392
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SU0015392
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Last modified
4/17/2023 10:37:02 AM
Creation date
4/3/2023 3:19:31 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0015392
PE
2632
FACILITY_NAME
PA-2300010
STREET_NUMBER
4215
Direction
E
STREET_NAME
MAIN
STREET_TYPE
ST
City
STOCKTON
Zip
95215-
APN
15728224, -11, -12
ENTERED_DATE
2/8/2023 12:00:00 AM
SITE_LOCATION
4215 E MAIN ST
RECEIVED_DATE
3/22/2023 12:00:00 AM
P_LOCATION
99
P_DISTRICT
001
QC Status
Approved
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EHD - Public
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NfaUIM C <br /> SAN JOAQUIN Environmental Health Department <br /> ! COUNTY — <br /> f411 <br /> OUNTY <br /> ` C'9 [. IFOFi�\P✓ Greatness grows here . <br /> WATER PROVISION DECLARATION <br /> Facility Business Name : La Tapatia Mexican Market INC . <br /> Facility Address : 2606 E Main Street Stockton CA 95205 <br /> Street City Zip <br /> Facility Business Owner Name : Rafael & Lorena Zepeda Phone : 209 - 401 - 7469 <br /> Property Owner Name : Rafael & Lorena Zepeda Phone : 209 - 401 - 7469 <br /> Property Owner Address : 3833 N Arata Road Stockton CA 95215 <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 ) : 0 <br /> 2 . Number of employees at the facility per shift : 20 Number of shifts : 2 <br /> 3 . Total number of employees , customers , and visitors at the facility per month , if variable : <br /> January 700 April 700 July 700 October 700 <br /> February 700 May 700 August 700 November $ 00 <br /> March 700 June 700 September 700 December 800 <br /> 4 . Number of days that total number of customers , visitors and employees frequent the facility per month : <br /> January 7 April 7 July 7 October 7 <br /> February 7 May 7 August 7 November 7 <br /> March 7 June 7 September 7 December 7 <br /> 5 . Number of yearlong residents : 0 <br /> 6 . Number of residents per month , if variable : <br /> January 0 April 0 July 0 October 0 <br /> February 0 May 0 August 0 November 0 <br /> March 0 June 0 September 0 December 0 <br /> I declare under penalty of perjury that the sta ements on this application are correct to my knowledge . It is the <br /> owner 's responsibility to notify this offi e if the water provision information of the facility changes . <br /> Facility Business/ Property Owner : Date : OCT 6 2022 <br /> S' ture <br /> 1868 E . Hazelton Avenue Stockton , California 95205 T 209 468 - 3420 1 F 209 464 - 0138 1 www . sjcehd . com <br />
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