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SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPAIA,..._AT --
<br /> SERVICE REQUEST ;an Joaquin County
<br /> SERVICEREOUESTP Dp4Ut"' Envi, nental Health Department DIRECTOR
<br /> inclLlrYlos
<br /> Type of Business or Properly ?._�"'.oma unda Turkatte,REF 3
<br /> RE.nNUc7I�W/ Q B yzAPIV' r:' .y 1868 East Hazelton Avenue
<br /> N( N PROGRAM COORDINATORS
<br /> rr��t Stockton,California 95205-6232 Robed MGCIaIIGn,REHS
<br /> OWNER/OPLE`RATOR C.-ifBuxc AIM-199 Jeff Cenuasco.RENS,RDI
<br /> _ [�LILIA LLrnYd GY=o rRY'rvrY4J4At7 A6LQZf11/L. ..OgCiFORts 3.. Website:WWW.Sfgovorg/efrd Kasey Foley,RENS
<br /> FACIniv NAME ( )u NTt7�1D Phone: 209 468-3420 Rodney Estrada,REHS
<br /> Adrienne Ellseesaer,REHS
<br /> 1I1E ADORr55 �a, j1' 5T0&_P:i,J Fax:(2°9)464-0738
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<br /> f•YEYip�su..l:wmx.. GW.N
<br /> C./'HO (3A ANC l�
<br /> Ha.IE Or MNLING Al1OREi$(II Diderenl from Slt4 Address) September 21,2015
<br /> su.x x„me.r
<br /> Cltt _ .. _ _ STATE __ _ ZIP— --
<br /> _ ATTN: Maria Bridges(Authorized Agent)
<br /> F'tv:F❑ Eu' APNa IANC USE A",'CATIONkHeadwaters Construction,Inc.
<br /> -S`L37 50 Fullerton Ct.Suite 203
<br /> Fusee r2 _ ,.— eos DlermeT La.."..Co.. Sacramento,CA 95825
<br /> S13 97
<br /> CONTRACTOR/SERVICE REQUESTOR RE PROPOSED: Taqueria San Antonio
<br /> cxacN ire LL x.AGOREssI� 4011 E Morada,#150
<br /> REDDE$TDR
<br /> /llAauW Yelarb n,,r. e _90-- Stockton CA 95212 SR0072948
<br /> BUSINE95 NAME,I__ 9G
<br /> lKTxsWATERs l Yr,Eu w+ad YNG iAxE
<br /> HostEor MAILING ADDRESS /y- Dear Michael:
<br /> sv u e�To Gr. S s r G - 9�--
<br /> CIT SAc STaTEf:A ZIP s- 459.74 This letter indicates San Joaquin County Environmental Health Department(EHD)approval of
<br /> BILLING ACKNOWLEDGEMENT:I,the undersigned property or business owner,operator or authorized agent of same, drawings submitted for the proposed TagUerla San Antonio, subject t0 the following
<br /> .InoWledge Ibe,
<br /> all silo and/or proJecl aped I. ENVIRONMENTAL H—RI DEPARTMENT hourly charges associated Will:this projector
<br /> COnditl0n(S):
<br /> aclWily will he billed to rra Gr u business as identified on this form.
<br /> I also ceney that I have prepared this application and that the Work to be performed will be done In accordance with oil S.w J—uol 1. All manufactured and custom-made food service equipment must be certified for
<br /> car-Online—Codes.standards.S—EandFecs—Is- �7 sanitation by an American National Standards Institute (ANSI) accredited
<br /> APPLICANT'S SIGNATURE: r4oN..0 d... t�,, x t�V DATcertification program. All proposed equipment is subject to EHD approval[CRFC
<br /> PROPERTY/BUMNE55 OWNER P—TOR/MANAGER❑ OTHERAUTNORMEO AGENT §1141301
<br /> IfAmu,wr is not lhefl—No PARTY pneofolauthorhailon to sign is required Till,
<br /> AUTHORRA710N TO RELEASE INFORMATION:When applkaWe,I,the owner ar operator of the property located at the above 2. The floor surfaces in all food preparation or packaging areas,open food storage
<br /> sit.address,hereby authorize the release of any and all rwulls,geotechnical data and/or envlronmentallslte assessment infarmalton areas, utensil washing areas, refuse storage areas, janitorial areas, and all
<br /> In the SAN JoA CouNTY ENVIRONMENTAL HEAETH D—TMENT as soon as it Is available and at the Same time it is provided to me M r restroom and employee change areas, shall be smooth and of durable
<br /> ny representelive.
<br /> construction and nonabsorbent material which is easily cleaned. These floor
<br /> TYPE OF SERVICE REQUESTED: I surfaces shall be coved at the juncture at the floor and wall with a three-eighths
<br /> CGuvrms: /L /^, (3/8) inch minimum radius coving and shall extend up the wall at least four(4)
<br /> hly emzl � FYrj� P-�1U inches. Rubber or vinyl top set base is not permitted in these areas[CRFC
<br /> 1 e §114268].
<br /> Urnve�h�C �lulimh® T
<br /> 3. All displays for unpackaged food must be shielded so as to intercept a direct line
<br /> AccEPree Br: EM /
<br /> EMPLOYEE II: °An: between the customer's mouth and the food. The display should meet the EHD
<br /> ASSIGNEE TO: EMPLOYEE a: DATE: guidelines for self-service buffets[CRFC§1140601. Sneeze guards shall be a
<br /> Dafe Service Completed(Ir alrnay omplelaa): SE—E C. PIE: O minimum of 54 to 60 inches above floor to intercept a direct line between
<br /> customer and food.
<br /> '+> Payment Date gas TS
<br /> Amount Paid 90.
<br /> F.P Amount: () � oD
<br /> Payment Type Invoices Checks t Received ey: 4. All ice machines and bins, food preparation sinks, warewashing sinks
<br /> (dishwashing units),display cases and refrigeration units,and any other food
<br /> AUG 2 0 2015 SR FORM(Gilden Rad)
<br /> E1ID4e.0a025
<br /> mn Roe SAN JOAQUIN COUNTY
<br /> NVIROMENTAL
<br /> c A1 TTI DEPARTMENT
<br /> u
<br /> Taqueria San Antonio 912112015
<br /> 4011 E Morada,#150 Page 2
<br /> Stockton CA 95212 SR0072948
<br /> service equipment which discharges liquid waste,shall be drained by means of
<br /> indirect waste pipes discharged through an air gap into a floor sink or other
<br /> approved waste receptor. All floor sinks are to be positioned to be readily
<br /> cleanable,accessible for inspections,and must be flush with finished floor. Do
<br /> not place floor sinks inside walk in refrigeration units or cabinets[CRFC§114193
<br /> and§114193.11.
<br /> The EHD must be kept informed of the construction progress. A final inspection must be
<br /> performed,operating permit fees paid,and approval to operate granted prior to opening for
<br /> business. All equipment must be installed and thorough cleaning completed prior to the final
<br /> inspection. Inspections must be scheduled at least 48 hours in advance. Charges for additional
<br /> inspections, re-inspections and/or consultations may be assessed at the EHD hourly rate of
<br /> $130 per hour.
<br /> Any item(s)Inadvertently overlooked in the plan check process,which is not in compliance with
<br /> applicable Slate laws, and/or city or county ordinance codes, shall be constructed or
<br /> reconstructed upon request of the EHD.Inferior workmanship,equipment,or materials will not
<br /> be accepted for the construction or operation of a food facility. Any variance from the
<br /> requirements outlined in this letter will require written approval from the EHD. Approval of the
<br /> submitted plans shall become null and void If the work authorized is not commenced within 180
<br /> days from the date of approval,or the work authorized by such plans is abandoned. In order to
<br /> renew action on an expired plan approval,the applicant shall submit fees equal to that of a new
<br /> plan review. A copy of the approved plans shall be available on site at the time of final
<br /> inspection.
<br /> If you have any questions,please contact Jeffrey Wong,Senior Registered Environmental
<br /> Health Specialist,at(209)468-0335.
<br /> Sincerely,
<br /> Jeff Carruesco,REHS,RDI
<br /> Program Coordinator
<br /> JC
<br /> Plan aR k
<br /> 7nsro9
<br />
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