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= opnuinjcGZ SAN JOAQUIN Environmental Health Department <br /> �, o <br /> Q - A <br /> COUNTY <br /> ? kiFoFaGreatness grows here . <br /> WATER PROVISION DECLARATION <br /> Facility Business Name : <br /> George Perry and Sons , Inc <br /> Facility Address : <br /> 13881 S Highway 99 , Manteca , CA . 95336 <br /> Street City Zip <br /> Facility Business Owner Name : Phone : <br /> Property Owner Name : <br /> AG Enterprises , LLC Phone : 209 -249 - 2400 <br /> Property Owner Address : PO Box 2588 , Manteca , CA . 95336 <br /> Street City Zip <br /> WATER PROVISION INFORMATION <br /> 2 <br /> 1 . Number of houses , mobile homes , or other occupied buildings served by the water well (s ) : <br /> 15 1 <br /> 2 . Number of employees at the facility per shift : Number of shifts : <br /> 3 . Total number of employees , customers , and visitors at the facility per month , if variable : <br /> January 10 April 10 July 25 October 25 <br /> February 10 May 25 August 25 November 10 <br /> March 10 June 25 September 25 December 10 <br /> 4 . Number of days that total number of customers , visitors and employees frequent the facility per month : <br /> January 20 April 20 July 225 October 225 <br /> February 20 May 20 August 225 November 20 <br /> March 20 June 225 September 225 December 20 <br /> 0 <br /> 5 . Number of yearlong residents : <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 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 /> 7 -22- 20 <br /> nature <br /> 1868 E . Hazelton Avenue Stockton , California 95205 1 T 209 468-3420 F 209 464- 0138 www . sjcehd . com <br />