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� .�2300279 <br /> SAN JOABUIN Environmental HealtFt Department <br /> COUNTY <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: Wildcat Renewables, LLC <br /> Facility Address: 11620 E Copperopolis Rd Stockton, CA 95'125 <br /> SVeel Coy Zip <br /> Facility Business Owner Name: Wildcat Renewables. LLC Phones: <br /> Property Owner Name: The Belli Family Trust Pnone: <br /> Property Owner Address: N/A <br /> slreal city vp <br /> WATER PROVISION INFORMATION <br /> t. Number of houses, mobile homes, or other occupied buildings served by the water well(s):� <br /> 2. Number of employees at the facility par shift: N/A Number of shifts: N/A <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: - <br /> January N/A April N/A July N/A Oc\ober N/A <br /> February N/q Mey N/a AUOua\ N/A November N/A <br /> MaroM1 N/A Junes N/A Sap\amber N/A Daaambar N/A <br /> 4. Number of days that total number of cuatomera, vialtors and employees frequent the facility per month: <br /> January N/A April N/A July N/A OMeber N/A <br /> Fgbruvry N/A May N/A Auguai N/A November N/A <br /> Marcb N/A Junes N/A September N/q Daoambar N/A <br /> 5. Number of yearlong residents: � <br /> 6. Number of residents per month, if variable: <br /> January O April O July O Oc[ober O <br /> Fabrua\y D May O Auguat O November O <br /> MarcM1 O Junes O 9eptambar O Oecamber O <br /> /dec/are under Pana/ty of perjury that the statements on this app/ication are correct to my know/edge- /t is the <br /> owner's responsibi/ity to notify t�his�oaffice/f the water pro v/slon Information of the facl/ity changes. <br /> acility Business roperty Owner: O �'K� mate: �2/4/23 <br /> sic�awra <br /> 1868 E. Hazelton Avenue I Stockton,California 95205 I T 209 468-3420 F 209 464-0138 I www.sjcehtl.eom <br />