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BILLING_PRE 2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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1900 - Hazardous Materials Program
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PR0540032
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BILLING_PRE 2019
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Entry Properties
Last modified
3/23/2021 10:08:54 PM
Creation date
6/9/2018 8:55:09 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
BILLING
FileName_PostFix
PRE 2019
RECORD_ID
PR0540032
PE
1920
FACILITY_ID
FA0022882
FACILITY_NAME
OAKLAND PALLETS
STREET_NUMBER
410
Direction
E
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
02
SITE_LOCATION
410 E GRANT LINE RD STE A
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\G\GRANT LINE\410\PR0540032\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
8/18/2017 10:22:22 PM
QuestysRecordID
3594745
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN JOAQ IN COUNTY SORONMENTAL HEALTH DEPA ENT <br /> MASTERFILE RECORD INFORMATION ORM <br /> ❑ New EH Program at Existing Facility New EH PGogr m and New Facility <br /> Facility IDProgram Record IDD3Z- <br /> Facility Address */0 72wc-L 'C! Jr7 <br /> (Please check the appropriate description and specify size, number of units andlpeitinent information.) <br /> FOOD PROGRAM(1600) <br /> ❑ Restaurant: Seating Capacity_ Square Footage Food Handlers Course required: YES ❑ No ❑ <br /> ❑ Commissary ❑ Dry storage only ❑ with Food Preparation OVending Machines Number of Units <br /> ❑ Retail Market----Square footage ❑ w/Meat Market only ❑ Mul iple Departments❑ Prepackaged Goods Only <br /> ❑ Mobile Food Vehicle--Make Vehicle Type Color <br /> Registration# License# Sticker# <br /> ❑ Mobile Food Prep Unit--Make Vehicle.Type Color <br /> Registration# License# Sticker# <br /> ❑ Temporary Food Facility--Dates of operation from to ❑ Ice Plant❑ Produce Stand <br /> ❑ Special Event---Dates of operation from to <br /> El CFO ❑ A ❑ B <br /> DAIRY PROGRAM (2000) <br /> ❑ Grade A Dairy ❑ Grade B Dairy ❑ Milk Dispen r- umber ntainers in Multi-Head Unit_ <br /> COUP—A <br /> 25 Hazardous Materials Business Plan (1900) Number of chemicals: '1 " <br /> ❑ CaIARP Program ❑ Program 1 Facility ❑ Program 2 Fad lity El Program 3 Facility <br /> El Hazardous Waste Generator(2200)--------> Tons Generated Per Year <br /> ❑ Tiered Permitting Facility-------> ❑ CA(2232) ❑ CE(2233,2234,2235,2,37) ❑ PBR(2231) ❑ PER HHW(2236) <br /> ❑ Aboveground Storage Tank Facility(AST) (2800) Number of ASTs <br /> ❑ Underground Storage Tank Program (UST) (2300) Use UST A and B forms <br /> ❑ Other CUPA Program <br /> HOUSING PROGRAM(2400) <br /> ❑ Hotel/Motel------Number of Units ❑ Jail or Exerr pt Institution----Number of Units <br /> Employee Housing(2700) Use Employee Housing/Labor Camp Application Form <br /> SITE MITIGATION(2900) UNDERGROUND INJECTION CON TROL(3000) <br /> ❑ Environmental Assessment ❑ UST-CAP Site ❑ Local HW Cleanup Site ❑ NPL/SEP Cleanup Site ❑ UIC Site <br /> ❑ Abandoned HW Site ❑ non-NPLISEP Cleanup Site ❑ RWQCB C ear up Site ❑ Water Quality Remediation Site <br /> RECREATIONAL HEALTH PROGRAM(3600) <br /> Number of Pools/Spas at Facility_ ❑ Pool ❑ Spa ❑ Out of Z ervice Pool/Spa ❑ Natural Bathing Area <br /> VECTOR CONTROL PROGRAM(4000) <br /> ❑ Poultry Farm-------Maximum number of birds ❑ Kennel <br /> TATTOO BODY PIERCING PERMANENT COSMETIC PROGRAM (4100) <br /> ❑ Body Art Practitioner Reg (4110) ❑ Mechanical DSPS Notification (41 P) ❑ Body Art Facility-Single Use(4120) <br /> ❑ Body Art Facility-Sterilization (4121) ❑ Body Art Temp Event Co-ord(4 30) ❑ Body Art-Temp Event Mobile Facility(4131) <br /> LIQUID WASTE PROGRAM(4200) <br /> ❑ Pumper Vehicle Registration# License# C apacity Vehicle# <br /> ❑ Pumper Yard —ff Package Treatment Plant ❑ Chemic 31 Toilets--Number of Units <br /> SOLID WASTE PROGRAM(4400) I, <br /> ❑ Landfill ❑ Transfer Station ❑ Ag/Cannery Waste Site ❑ Sludge/Ash Site <br /> ❑ Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Fac lity ❑ CIA Landfill Site <br /> ❑ Refuse Vehicles p of units) ❑ Dumpsters>20 cu yd (#of Units) ❑ Farm/Ranch Cleanup Site <br /> MEDICAL WASTE PROGRAM(4500) <br /> ❑ Primary Care ❑ Acute Care ❑ Skilled Nursing ❑ Large Generato ❑ Small Generator ❑ Limited Hauler <br /> ❑ Transfer Station ❑ Veterinary Clinic ❑ Common Storage Facility 112-10 011 -60 ❑ >60 generators <br /> PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Applicati n Form <br /> EMERGENCY NOTIFICATION FOR THIS FACILITY'AN /OR PROGRAM <br /> CONTACT PERSON Day Ph Night Ph <br /> PROGRAM ELEMENT 192-0 FEE /7C oe Surcharge F E t? ❑ Other FEE <br /> INSPECTOR# � '�- y PERMITVAUD Lo1,to - ❑ Food Handler <br /> ❑ Check# A MOUNT PAID Date �I INVOICE# �'�✓" ��G <br /> ❑ Cash REVIEWED BY ACCOUNTING OFFICE Date }( <br /> 48-02-034 MASTERFILE RECORD INF RMATION PINK <br /> 1/23/13 <br />
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