Ambulance services — and the impacts they have on fire protection — is underscored in the San Joaquin County Emergency Medical Systems System Assessment completed in April. In Ripon, the fire district is heavily subsidizing its ambulance service through property tax. In Manteca, due to not just the financial viability of Manteca District Ambulance but also its level of service, City of Manteca taxpayers are avoiding $2 million in annual costs.