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S A N J 0 A Q U I N Environmental Health Department <br /> COUNTY <br /> WATER PROVISION DECLARATION <br /> Facility Business Name: Manteca Sportsmen Inc <br /> Facility Address: 30261 S Airport Way, Manteca, CA. 95337 <br /> Street City Zip <br /> Facility Business Owner Name: Manteca Sportsmen Inc Phone: (209) 823-7919 <br /> Property Owner Name: Manteca Sportsmen Inc Phone: (209) 823-7919 <br /> Property Owner Address: 30261 S Airport Way, Manteca, CA. 95337 <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):2 <br /> 2. Number of employees at the facility per shift: 1 Number of shifts: 2 <br /> 3. Total number of employees, customers, and visitors at the facility per month, if variable: <br /> January 372 April 497 July 228 October 248 <br /> February 347 May 398 August 269 November 289 <br /> March 422 June 301 September 306 December 231 <br /> 4. Number of days that total number of customers, visitors and employees frequent the facility per month: <br /> January 31 April 30 July 31 October 31 <br /> February 28 May 31 August 31 November 30 <br /> March 31 June 30 September 30 December 31 <br /> 5. Number of yearlong residents: 2 <br /> 6. Number of residents per month, if variable: <br /> January 2 April 2 July 2 October 1 2 <br /> February 2 May 2 August 2 November 2 <br /> March 2 June 2 September 2 December 2 <br /> 1 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 /> JFacility Business/Property Owner: Date: 6/26/2025 <br /> gnature <br /> 1868 E. Hazelton Avenue I Stockton, California 95205 1 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />