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SJ COUNI Y PI IS-kNVInUrIMEN I/LL I1FAL I II inviurldlkrn..o.....r..� ..� .......................... tom.. __ __.._..____._..� <br /> Naw Ell Program/Exleting Facility New EII Progren1m F ilily Uete <br /> SHADED SECTIONS FOR LOCAL USE ONLY <br /> FACILITY ID # -7 7S Y RECORb IDN <br /> Plane@ Mark the Approprlele DeecripUon and Specify Size and/or Number of Unite where appiioebhn <br /> DAIRY PROGRAM {2000} <br /> Gude A Dairy Made a Dairy Mllk Dhpor••r Nunbn of CONain.n In MNtl Hud Ud1 <br /> r . <br /> Foot) PROGRAM {1600} <br /> 1 C.P.01, 1 saner•Footeg• p oduce Stand Ice Plant <br /> estatrant <br /> I t s xY 1 web Food Pr...tex.n V n 16 o l Me i t Number of U41. <br /> Commissary <br /> 1 8 F 1 will,Mut Mwk•1 odY I .111,FcoA Pr•rnnxnn 1 Dry OooJ•only <br /> Retell Market <br /> 1Mnb I Vdicl•Trip. � CWor i Reputation I � Ue•me i <br /> Food Vehicle I 1 <br /> 1 funk. V.14.1.TYPe I Color Postured..a i LIcmu <br /> Mobile Food Unit 1 <br /> Temporary Food Facility Special Event <br /> Deb.of Onerexan bom m pate.of Opa�atlon Iron to <br /> HAZARDOUS WASTE PROGRAM {2200} <br /> 1 Tong generated per year <br /> Hazardous Waste Generator t - - <br /> � Catepadadly eulhodr•J 1 Ceteporlpnlly Faanpt P.rmlt LY PWe <br /> Tiered Permit Facility <br /> _ DOUSING PROGRAM {2400} _ EMPLOYEE HOUSING {2700} <br /> I Nunbn of UNte Namb.r of onpl..... Dairy FmPIoY•• Ilmulnp <br /> Hotel Motel <br /> APrradmeu Delo of 0•oupenuy to <br /> Jail or Exempt Institution <br /> _LIQUID WASTE PROGRAM {4200} <br /> l a d n s 1 ue.n••• I capacity <br /> Pumper Vehicle <br /> 1 Nunbn of UNte <br /> Pumper Yard Package Treatment Plant Cltamlcal Toilate <br /> 1 <br /> _ MEDICAL WASTE PROGRAM {4500} <br /> rimer Care Acute Care Skilled Nursing Lar a Generator <br /> Smell Generator Transfer Station Limited Hauler Veterinary CIIDic <br /> 2-10.•..rotor. I 11 .60.•....tm. >so g•n.nw�. <br /> Common Store a Fecil!1 <br /> _RECREATIONAL HEALTII PROGRAM {5600} <br /> Pool Spe Out of Service onl S e Nal r 1 B tl Ina Area <br /> Nunbn of 1`0016/81-. al Fool"', I Pod/sr•to/ <br /> _ SrrE MmGA"ON PROGRAM {2900} <br /> Environmental Assessment 1• SV UST/CAP Local He. Waste Hez Met Pipeline <br /> I Cd EPA-PWOCe I Cd EPA-DTBC I UB�EPA <br /> Other Lend Agency Site ! <br /> I NPL Blu 1 water OunIItY site 1 Olnn <br /> _SOLID WASTE PROGRAM {4400} <br /> Landfill Transfer Station AnICturnfory Wselo Site <br /> Number cl Vito <br /> CIA Landfill Site Sludge/Ash Site Compost Facility Reluea Velllclee <br /> Number of UNb <br /> Waste Tire Facility Process/Ree cle Facility Dum eters >20 cu d <br /> _VECTOR CONTROL PROGRAM {4000} <br /> Meabnun Nunbn of slid. Kennel <br /> Poultry Farm <br /> Day Nlpin <br /> 6mrg•rwy Notification for 1N•FACILITY and/or PFWWAM q <br /> CONTACT PERSON- ncr S(' r - O <br /> Program Dimenj R Cunmt aOtte Nubb•1 0l udu EPA ID F <br /> D•dg�uud DnploYee <br /> int• I t m 6au— <br /> we e. y Data w awes 'y tito comm tip 7 a• nu <br /> F 17Ti C1a <br /> NZ ?,/L 7 <br />