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Please provide all information requested; an incomplete application may delay approval <br /> ❑ FACILITY INFORMATION <br /> Name of Facility: McDonald' s Restaurant <br /> Street Address: 300 Louise Ave . <br /> City: Lathrop Zip Code: 95330 <br /> ❑ FORMER NAME OF FACILITY <br /> ❑ BUSINESS OWNER INFORMATION <br /> Business Owner Name: Tim Darnell - McDonald ' s USA, LLC <br /> Home Address: 2999 Oak Road Suite 900 Walnut Creek, CA 94597 <br /> Mailing Address: <br /> Telephone Number: 925-949-2055 <br /> ❑ PROPERTY OWNER INFORMATION <br /> Property Owner Name: Tim Darnell - McDonald' s USA LLC <br /> Home Address: 2999 Oak Road Suite 900 Walnut Creek, CA 94597 <br /> Mailing Address: <br /> Telephone Number: 925-949-2055 <br /> ❑ CONTRACTOR INFORMATION <br /> Name of General Contractor: TBD <br /> Mailing Address: <br /> Telephone Number: <br /> Contact Person on Site: <br /> Site Phone Number: <br /> ❑ UTILITIES ) <br /> Source of Facility Water Supply: City of Lathrop <br /> Backflow Protection: Yes _ <br /> System to be used for Liquid Waste Disposal (Sewage): Sewer System <br /> Solid Waste Disposal to be provided: Yes <br /> Grease Interceptor: Yes <br /> ❑ FOOD INFORMATION <br /> List food(s)to be served and/or provide menu: ECJ <br /> O OPERATIONAL INFORMATION' <br /> Anticipated Business Hours: Open: 24 hours Close: <br /> Anticipated Number of Employees: 6-8 <br /> EHD 16-01 4 PLAN CHECK GUIDE <br /> 8/1/14 <br />