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GENERAL P2MRAMFILE4• ; 19 FROM LF ROSEUILLE <br /> New cue Ea,tPRGE . 002 <br /> "'-# <br /> # I�rISQV 7fGlfr.a <br /> FACILITY to i . <br /> FACItdTT x&mg <br /> cEcoaD to , ,� <br /> PRIOR S4EEPS/[DIP , <br /> DAIRY: Crede A Dade B 11th Olv <br /> Deicer lumber of Containers in Mutt[-Rand Ltd t <br /> __. FOWs Restaurant _ Ilsrkat Coealssa <br /> Seating Capacity 7 h�loblle Food Predate Stand It* Plant <br /> n'��'ora7 Food Facility <br /> Speefat Food Event SQ Ft „ '^ Harket w/Food Prep: T / a <br /> r <br /> Food Vehicle make Yerding M6chir*3 llutber of Yerdirlq units <br /> ticmue ! tpiatratfon I <br /> � Coto? <br /> MAZAADWS WASTE: TontQ -- <br /> erleratad/Tr TIERED PERMIT Facility : CA <br /> CLT PBt <br /> f1CATSfHCi Aote(/Notel le. of knits �- <br /> Eap(eyee Rousingle. of ( Jall/Esaept Institution liouofrp Abatement <br /> Eap Drees Appryt Oates of O=Upw�r <br /> LICUID VAST@: ptx"r Vehiel• Ptnplvr Terri <br /> Ch*alesl Toilets No. Package Tic Plant <br /> WDiCAL VASTE! PrImwy Cir# Mute Care Stitted NtrainQ L Cererator <br /> Storage (Z-10) Storage (11.50) Stor a 0 9 Cer>+rater <br /> v9 ( ,,5 ) _. Transfer Scs Ltd Hauler Vat CLinic _ <br /> R�ECREAtICRAL AEALTFit Pool/Sp+! Murber of Foals OM of Servic* Pool Natural gathirq place <br /> f/ SITE MITIGATION: Errviran At. s ! UST/ctP Mar Vast* Roz Not PDL <br /> Other Coed Agsrcr Site Agency! QL70C8 I'SC RPL Site RBlit20 Q Oth*r <br /> SOLID 'LISTS: Landfill Trwaf*r Sts Recyelirq Fac Waste Storage Fac AS vastt/ExeMt Site <br /> SW Vehicle so. DLapet*r ,o. Stationary Coepietor Site <br /> VECTOR CONTROL: Poultry Fares kax *-sheer of 81rds CArral <br /> MRCEMCT NOTIFICATION for this FACILITY and/or PtootAM OAT W^ NICHT <br /> COutACT 1 Steven M. Ferrara ( 213)486 - 7785 (213 ) (pager)812 - 6821 <br /> CORTACT Z : John J. Mason ( 209)465 - 7369 (916 ) 863 - $0 <br /> DESILRATO 9TLOTEE s PROf3m FUME)1T Cattm STAM <br /> S OF UXITi EDA to ,: eRSP6CTIOi1 OtbE <br /> $KLM: and IANCE AOOOILWIO' NT! 1, the tzA"tgrnd ourwr•, operst*r or agent of sea, sefasarledy* that AL sit* and/or <br /> projoct Tp-elf(c PRS/END ho rlT durpes aasoelated with thts Fseility or activity vitt be bliled to th* Dart . identified at the <br /> BILLiMa PAIIIT — this fora. I visa certify that t hove prep.rtd this aDpiteation arta that the wort to be perfona*d will, be done <br /> in sccerdmxt with alt atplieatA* SA,i JMOUIY CLIJNr'r Ordinance Cades vrd/or Stx-dards and State ardor Fod*rtl taus. <br /> APPLIC111T'S SIGatArURE : Ai�tiG� <br /> Patrick L. very <br /> Title: vice President, Environmental & S&fetv Dates SeTSt. 6, 1994 <br /> At nNORIZATIO>t TO RELEASE IMFORMATICSt In addition to the sbere• when applicable, E, the aver, operator or *pert,- of &Moo of <br /> the prmercy located at t!r* above site address hereby maharite the release of arrlr and ail ?*sults, geotechnical data andlor <br /> errvtrormentat/sift v ses=-t inforatien to SAs JOAMIM alillTT PMJC MULTI; SERYIMS tOtVlR0@",AL HEALTH DiWI3ICst as soon ss <br /> it is Wettable and at the same titer it is provided to,nw or W raprasanestfve. <br /> ret Amount Amount Paid Oat* of Pareer+t PSYWM a Type Recelpt AT Qneck !t [*cud ay <br /> , 1 <br /> 1 <br /> aEHS _f`J SIPV l fr..�/ ACCT __J_� UNIT C1L .rf�f <br />