My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
BILLING
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
C
>
CAROLYN WESTON
>
520
>
1600 - Food Program
>
PR0518527
>
BILLING
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
12/7/2023 1:52:38 PM
Creation date
12/7/2018 11:22:02 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0518527
PE
1624
FACILITY_ID
FA0013954
FACILITY_NAME
WINGSTOP
STREET_NUMBER
520
STREET_NAME
CAROLYN WESTON
STREET_TYPE
BLVD
City
STOCKTON
Zip
95206
APN
16422011
CURRENT_STATUS
01
SITE_LOCATION
520 CAROLYN WESTON BLVD STE A
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
FilePath
\MIGRATIONS\C\CAROLYN WESTON\520\PR0518527\BILLING.PDF
QuestysFileName
BILLING
QuestysRecordDate
6/22/2017 11:12:03 PM
QuestysRecordID
3459605
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
10
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
F-HTrilItNT <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT RECEIVED <br /> MASTERFILE RECORD INFORMATION FORM .SUN 2 2 2017 <br /> ❑ New EH Program at Existing Facility ❑New EH Program and New Facility ,4NJOA <br /> QUIN COUNTY <br /> Facility ID Program Record ID ENVIRONMENT <br /> Facility Address �aC? 25{ U A S ��TI�0NT <br /> (Please check the appropriate description and ecify size, number of units and pertinent information.) <br /> FOOD PROGRAM(1600) ' 11/ <br /> Restaurant: Seating Capacity YCb Square Footage 1 Lao Food Handlers Course required:' YES�KNo ❑ <br /> ❑ Commissary 1:1Dry storage only ❑ with Food Preparation ❑Vending Machines Number of Units <br /> ❑ Retail Market----Square footage ❑ w/Meat Market only ❑ Multiple 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 ❑ CFO ❑ A ❑ B <br /> DAIRY PROGRAM (2000) <br /> ❑ Grade A Dairy ❑ Grade B Dairy ❑ Milk Dispenser-Number of Containers in Multi-Head Unit <br /> CUPA <br /> ❑ Hazardous Materials Business Plan (1900) Number of chemicals: <br /> ❑ CaIARP Program ❑ Program 1 Facility ❑ Program 2 Facility ❑ Program 3 Facility <br /> ❑ Hazardous Waste Generator(2200)----------> Tons Generated Per Year <br /> ❑ Tiered Permitting Facility-------> ❑ CA(2232) ❑ CE (2233, 2234, 2235, 2237) ❑ PBR(2231) ❑ PBR HHW(2236) <br /> ❑ Aboveground Storage Tank Facility(AST) (2800) Dumber of AST's <br /> ❑ Underground Storage Tank Program (UST)(2300) Use USIA and B forms <br /> ❑ Other CUPA Program <br /> HOUSING PROGRAM(2400) <br /> ❑ Hotel/Motel------Number of Units ❑ Jail or Exempt Institution ----Number of Units <br /> Employee Housing (2740) Use Employee Housing/Labor Camp Application Form <br /> SITE MITIGATION(2900) UNDERGROUND INJECTION CONTROL(3000) <br /> ❑ Environmental Assessment ❑ UST-CAP Site ❑ Local HW Cleanup Site ❑ NPL/SEP Cleanup Site ❑ UIC Site <br /> ❑ Abandoned HW Site ❑ non-NPL/SEP Cleanup Site ❑ RWQCB Cleanup Site ❑ Water Quality Remediation Site <br /> RECREATIONAL HEALTH PROGRAM (3600) <br /> Number of Pools/Spas at Facility ❑ Pool ❑ Spa ❑ Out of Service 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 (4115) ❑ Body Art Facility-Single Use(4120) <br /> ❑ Body Art Facility-Sterilization (4121) ❑ Body Art Temp Event Co-ord (4130) ❑ Body Art-Temp Event Mobile Facility(4131) <br /> LIQUID WASTE PROGRAM(4200) <br /> ❑ Pumper Vehicle Registration# License# Capacity Vehicle# <br /> ❑ Pumper Yard ❑ Package Treatment Plant ❑ Chemical Toilets----Number of Units <br /> SOLID WASTE PROGRAM(4400) <br /> ❑ Landfill ❑ Transfer Station ❑ Ag/Cannery Waste Site ❑ Sludge/Ash Site <br /> ❑ Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Facility ❑ CIA Landfill Site <br /> ❑ Refuse Vehicles I#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 Generator ❑ Small Generator ❑ Limited Hauler <br /> ❑ Transfer Station ❑ Veterinary Clinic ❑ Common Storage Facility ❑ 2- 10 ❑ 11 -60 ❑ >60 generators <br /> PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Application Farm <br /> EMERG NOTIFICATION FOR THIS FACILITY AND/OR PROGRAM <br /> rte- ' <br /> CONTACT PERSON �ckaj1-1 Ltcs Day Ph — 0 Night Ph <br /> PROGRAMELEMENT L- FEE ' X ❑ Surcharge EE 1:1 Other FEE <br /> IN PECTOR# !��^ PERMIT VALID i t0 t ( 1:1 Food Handier <br /> LL�� <br /> Check# AMOUNT PAld OD Date �Zh INVOICE# `l <br /> ❑ Cash REVIEWED 13� ACCOUNTING OFFICE Date 4 2-3 <br /> 48-02-034 — MASTERFILE ECO INFORMATION PfNK <br /> 1123113 <br />
The URL can be used to link to this page
Your browser does not support the video tag.