Laserfiche WebLink
SANJOAQUIN Environmental Health Department <br /> --T—COUNTY <br /> Greatness groes here. <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: AutoMech �T <br /> Facility Address: 2662 N WILSON WAY , STOCKTON . C A 95205 <br /> stroet ' city Zip <br /> Facility Business Owner Name: SARFRAZ AHMAD TABISH Phone:209-663-3117 <br /> Property Owner Name: SARFRAZ AHMAD TASISH Phone:209-663-3117 <br /> Property Owner Address: 1012 WELLSWOOD CT , LODI CA 95240 <br /> Street City Zip <br /> WATER PROVISION INFORMATION <br /> 1. Number of houses, mobile homes, or other occupied buildings served by the water well(s).- Building <br /> 2. Number of employees at the facility per shift: 1 Number of shifts:1 <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: <br /> January 6 April 1 6 f July i 6 October 6 <br /> February 6 May 16 Aupuat 16 November 6 <br /> March 6 June 16 September 1 6 December 6 <br /> 4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br /> January 24. Aprll '24 j July 124 1October 124 <br /> February May 24 Augusl 124 J Novembar ,4 <br /> Me; 124Saptember 124 1 December 124 <br /> 5. Number of yearlong residents: <br /> 6. Number of residents per month, if variable: <br /> January April July October <br /> February May August J 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 /> I <br /> Facility Business/Property Owner: Date: 08/11/2021 <br /> ignature <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209464-0138 1 www.sjcehd.com <br />