Laserfiche WebLink
. 1 , <br /> $A N J Q A Q U j N Environmental Health Department <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: THC Logistics LLC <br /> Facility Address: 4674 E. Waterloo Rd. <br /> Street City Zp <br /> Facility Business Owner Name: Patrick Byron Phone:209-329-6437 <br /> Property Owner Name: Stockton Warehouse and Industrial Complex Phone:415-457-1629 <br /> Property Owner Address: 634 Mission Ave, San Rafael Ca. 94901-3209 <br /> Street City Zap <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: 2-3 Number of shifts: 1 <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: <br /> January ` April July October <br /> February i May i August November <br /> _March _ June_ - _ September _ _ December <br /> 4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br /> January April j July October <br /> T — <br /> February May f August November <br /> March I June September December <br /> 5. Number of yearlong residents: 0 <br /> 6. Number of residents per month, if variable: <br /> January April July October <br /> February May August November <br /> March June September ' December <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 if the water provision information of the facility changes. <br /> Facility Business/Property Owner: _ Date: <br /> Signature <br /> 1868 E. Hazelton Avenue i Stockton, California 95205 1 T 209 466-34201 F 209 464-0138 1 www.sjcehd.com <br />