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SA N J OA Q U I N Environmental Health Department <br /> C OUIJ TY <br /> ,..r�,ln , q. .v <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: Truck One <br /> Facility Address: 30022 Highway 33, Tracy CA 95304 <br /> SVcal Clly Zlp <br /> Facility Business Owner Name: CA33 LLc Phones: 312 912 1833 <br /> Property Owner Name: CA33 LLc Phone: 312 912 1833 <br /> Property Owner Address: 14151 Newport Ava. Ste. 203 Tustin CA 92780 <br /> Street City Zlp <br /> WATER PROVISION INFORMATION <br /> 1. Number of houses, mobile homes, or other occupied buildings served by the water wall(s):2 <br /> 2. Number of employees at the facility per shift: 9 Number of shifts: 3 <br /> 3. Total number of employees, customers,and vlsltors at the facility per month, if variable: <br /> January 3.000 Aprg 3,000 JuIY 3,000 October 3,000 <br /> February 3,000 May 3,000 Augual 3.000 November 3,D00 <br /> Mereb 3,000 Junes 9,000 September 3,000 Dacvmbar 3,000 <br /> 4. Number of days that total number of cuatomara,visitors and employees frequent the facility par month: <br /> January 3t Aprll 30 July 31 October 31 <br /> February 28 May 9'I Auguat 3'I Nevember 30 <br /> Mereb 3'1 Junes 90 9ap[ambar 30 Decrembar 3t <br /> 5. Number of yearlong residents: O <br /> 6. Number of residents per month, if variable: <br /> January O Aprll O July O October O <br /> FabNary O May O Auguat O Npwmbar O <br /> Mereb O Junes O 3eptambar O December O <br /> /dec/are under penes/ty of perJury that the statements on thJs app/ication are correct to my Knaw/edge. /t is the <br /> owner's rasponsibi/ity to notify this offic�Cif the water pro vis/on/nformation of the facf//ty changes. <br /> Facility Business/Property Owner: �I.y ba.�ar yaihi Date: 1/23/2024 <br /> sla.�aw.a <br /> t868 E. Hazelton Avenue Stockton, California 95205 I T 209 468-3420 F 209 464-Ot 38 www.sjcehd.com <br />