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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, CA 95205-6232 <br /> • �... _ P Telephone: (209)468-3420 Fax:(209)464-0138 Web:www.sigov.org/ehd <br /> QLtkoR�'� <br /> Food Program Service Request Inspection Report <br /> Facility Name and Address: WAYBACK BURGERS, 3218 W GRANT LINE RD , TRACY 95304 <br /> NOTES <br /> There is currently a bulk tank of carbon dioxide(CO2)at the facility. Please be aware that CO2 is an asphyxiant and is <br /> therefore considered a hazardous material subject to regulation under Chapter 6.95, Health and Safety Code, Division 20, The <br /> reportable quantity for CO2 is 137 pounds or 1,200 cubic feet in San Joaquin County(SJC). You will be placed into the SJC <br /> Environmental Health Program for Hazardous Material Business Plan (HMBP)and will be required to report your hazardous <br /> materials in the California Environmental Reporting System (CERS). For more information or to comply with the reporting <br /> requirement in CERS, please go to: http://cers.calepa.ca.gov/ <br /> Please report by 30 days. <br /> OK to permit as a 1625 once annual permit fee is paid. <br /> Please return to 1868 E Hazelton Ave. in Stockton to pay the annual permit fee($376)and fill out appropriate paperwork by 2 <br /> business days. <br /> Permit will be backdated to 6-22-18 <br /> The person in charge is responsible for ensuring that the above mentioned facility is in compliance with all applicable sections of the California Health and <br /> Safety Code.If a reinspection is required,fees will be assessed at the current hourly rate. <br /> Received by: Name and Title: Tahir Pervez, Manager <br /> EH Specialist: KADEANNE LINHARES Phone: (209)468-0330 <br /> FA0023584 SR0079516 SC061 08/22/2018 <br /> EHD 16-23 Rev.06/30/15 Page 2 of 2 Food Program Service Request Inspection Report <br />