BILLING - Laserfiche WebLink

Home Browse Search

10/20/2005 16: 49 4640138 ENVIRONh1ENTAL HFAI'TH PAGE 03 SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT MASTERFILE RECORD INFORMATION FORA ❑New EH Provrarn at Existing Facility nNcw EH ProgM and New FacilitY Facili ID D 0 1 L, L, I Pro am Record ID P f o S7-474 Z— Facility Address 243 West Fremont Street. Stockton CA 95203 (please Check the appropriatc description and specify size,cumber of units and pertinent Information.) FOOD PROGRAM(1600) ❑Restaurant: Seating Capacity 0 Square Footage 0 Food Handlers Course required: S'ss❑ No ❑ ❑ Commissary ❑Dry storage only ❑ with Food Preparation ❑Vending Machines Number of Units ❑Retail Market---Squats footage ❑ with Meat Market only ❑Multiple Departments ❑ prepackaged Goods Only ❑ Mobile Food Vehicle---Make Vehicle Type Color Registration# License# Sti cker# ❑ Mobile Food Prep Unit--Make Vehicic Type Color Registration# License# Sticker# ❑ Temporary Food Facility—Dates of operation from to ❑ Ice Plant ❑ Special.Event —Dates of operation from to El Produce Stand DAIRY PROGRAM(2000) ❑ lA Grade A Dairy Grade R Dairy ❑ N1111k D4"ser---Number of Containers in Multi-Head Unit CUPA ❑ State Faclllty Surcharge(23W) HAZARDOUS WASTE PROGRAM(2200) ❑ Il�rdous Waste Generator—---Tons------Toros Gcucrated Per Year Cl Recycle/Exempt Sy�tera(2299) 0 CRT Offsite Handlers(2218) ❑ SiiN`er Only(2222) ❑Appliance Reeyclers(2217) Tiered Permitting Facility ❑ Conditionally Authorized(CA) ❑ ConditionaUy Exempt(CE) D Permit-By-Rule Fixed Unit ❑ Permit-By-Rule Household Hazardous Waste C]ABOVEGROUND STORAGE TANK FACILITY(AST)(2390) Number of AST UNDERGROUND STORAGE TANK(UST)PROGRAM(2300)Use UST and B orms HODS NG PROGRAM(2400) ❑ HotelfiNotel -Numbex of Units El JarT or Exempt Institution—Number of Units Employee Housing(2700) Use Emrfotre Housir+r/Labor Camp AyDllcalioR Form SITE MITIGATION(2900) UNDERGROUND INJECTION CONTRO_L(3000) [a Loco HW Cleanup Site ❑ NpL/SEP Cleanup Site ❑ UIC Site ❑ Environmental Assessment ❑ UST-CAP Site p ❑ Abandoned HW Site ❑ non-NPL/SFP Cleanup Site ❑RWQCB Cleanup Site ❑Water Qu9llty Rertrcdlation Site RECREATIONAL HEALTH PROGRAM(34600) Number of Pools/Spas at Facility ❑ Pool ❑ Spa ❑Oat of Service pooUSpa ❑Natural Bathing Area VECTOR CONT OL PROGRAM(4000) ❑ Kennel ❑ Poultry Farm Maximum number of birds TTATT0013ODY PIERC 1K©.PERMANENT COSMETIC PROGRAM(4100) © permanent Cosmetic%(4122) ❑ Tattooing(4121) ❑ Body Piercing(4120) LIgU1D WASTE PROGRAM(4z00) Vehicle 0 ❑ Pumper Vehicle—Registration# License 9 Capacity ❑ Pumper YaM ❑ Package Treatment Plant ❑ Chemical Toilets Number of Units SOLID WASTE PROGRAM(4400) ❑ Sludge/Ash Site ❑ Landfill ❑ Transfer Station ❑ pr/Cannery Waste Site ❑ proces_R/Recycle Facility ❑ CIA Landfill Site ❑Waste Tire Facility El Compost Facility ❑ Farrn/Ranch Cleanup Site ❑ Refuse Vehicles--Nurnbcr of Units ❑ Dumpstcts>2tl cu yd.--Number of Units MEDICAL WASTE PROGRAM(4500) c Generator ❑ Small Generator ❑Limited 14auler ❑ Primary Care ❑ Acute Care ❑ Skilled Nursing (]I-ary ❑ ]1 -GO—060 generators ❑Transfer Station ❑ Veterinary Clinic ❑ Common Storage Facility----❑ 2- 10 PUBLIC WATER SYSTEM PROGRAM(4600)Usc PFf"S FTND 46-I12-003 Slue A licatinn Form EMERGENCY NOTIFICATION FOR THIS FACILITY AHD/oR RROGRAM 209 518-8154 CON-TACT PERSON Patrick Bluso Day Ph (209) 518-8154 Night Ph rr ❑ Other FEF PRO4 R. fMELEME-IM �k Z _ FF.F. �Zt7 CI SurchargeFeE_ lN,.;r rCTOR# lJ q hLRMIT VALID to 1 Z 3 t ❑Food Handier I -Check# 1 / AMOUNT PAID — Date �I C 1.*rV0[CE LJ Cash REvmwmsy AccowrINGOFFICE Datc Y Q