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SANaJOAQUIN Environmental Health Department <br /> C OIJNTY-- <br /> WATER PROVISION DECLARATION <br /> Facility Business Nama: Valley Pacific Petroleum Services, Inc <br /> Facility Address: 3550 S. Rt 99 E Frontage Rd. Stockton, CA 953'1 S <br /> 3naat Ciry Zip <br /> Facility Business Owner Nama: Michael Arno1C (Project Manager) Phone: 209-715-3295 <br /> Propany Owner Nama: Yorktown Properties LLC phone: 209-7'15-3295 <br /> Property owner Address: '152 Frank West Circle Stockton, CA 95206 <br /> s.oat ary zip <br /> WATER PROVISION INFORMATION <br /> �. Number of houses, mobile homes, or other occupied bulltlings served by the water wall(s): � <br /> 2. Number of employees at the facility par shift: �5 Number of shifts: 2 <br /> 3. Total number of employees, customers, antl visitors at the facility par month, if variable: <br /> January April July Oo[obar <br /> February May Auguot Nevambar <br /> March Juna saptambar Dxambar <br /> 4. Number of days that total number of customers,visitors and employees frequent the facility per month: <br /> January April July Ootebar <br /> Febrpary May Augua! November <br /> March Juna September Oacombar <br /> 5. Number of yearlong residents: <br /> 6. Number of residems par month, If variable: <br /> January April July Oclebar <br /> February May Augus[ November <br /> March Juna 8aptambar December <br /> /dec/ata under pane/ty of perjury that the statements on this app/Icatfon are correct to my Know/edge. /t is the <br /> owner's responsibi/ity to notify this office ifit�he�wat/��r p�/o+visionnri�nfotmaticn of the faci/ity changes. <br /> Facility Business/Property Owner: � i ��c.-.y� C��C Date: �/09/2024 <br /> siv�em.. <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 I T 209 468-3420 I F 209 464-0138 I www.sjcehd.com <br />