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SJ COUNTY PIIS -ENVIRONMENTAL IIEALTfI DIVI: MASTF]RFII E P- ARD INFORMATION FORM (Ell 00 501H..l.ed 61941) <br /> Naw EII Prog_ram_IEeiating facility Naw Ell PrograntlNew Faoilily Date — -- --- —� <br /> S/IAUED SECT/ONS FOR LOCAL USE ONLY <br /> FACILITY 77ECORD ID # <br /> DAIRY PROGRAM {2000} Pleoea Mark the AppropriateSiva Desorlption and Speoify andlor Number of Unit.—liars applio.Lle: <br /> Onede A Udry Grad.B Dairy MIlk Dispenser Naulber of conldn.r•In MnW flood U,Jt <br /> c <br /> FOOD PROGRAM {1 600} y <br /> I 6aadnp capacity 1 6yu.re Foolag- <br /> Restaurant t t Produce Stand Ice Plant <br /> I pry 61mag•o,Jy 1 with Food pliop adun• Nunb•r o1 Uu41. <br /> CommlesnrY Vendh�q Machines <br /> I <br /> Sq--Foot.g. I with M..t Mmk.t u,Jy 1 wit,IFu d Pr.p.r.dmh I Dry ouud.o,Jy <br /> eteiJ Marknl t t <br /> I M.k. 1 V.Nale Type I color 1 Regl.ueUon / i Uo.n.e <br /> Food Vehicle 1 1 1 1 <br /> 1 1 1 1 1 <br /> 1 Mnk• I V•1J.10 Type 1 color I H.gl.uadon I l Uo•nu I <br /> Mobile Food Unit I 1 I 1 1 <br /> I 1 1 1 1 <br /> Temporar1 <br /> y Food Facility Special Event <br /> Del..of Oparadon from to Dote.of Operation from to - <br /> HAZARDOUS WASTE PROGRAM {2200} <br /> I Ton•g•narat•d per year <br /> E <br /> eWnstn Generator ' Cat•poilcdly euthorlr•d 1 Categorlodly Exampt Permit by RL4. <br /> nnil Facility <br /> HOUSING PROGRAM {2400} EMPLOYEE HOUSING {2700) <br /> I Nmhber of Uols Nunber of EinpWye.@ Ddry Eiopluy.. Huudnp <br /> Hotel <br /> tel <br /> Approxhnm. Dot..of 0...V.noy <br /> Jail or Exauryrt Institution to <br /> UQUID WASTE PROGRAM {4200} <br /> 1 Regletradon I ( "c•n.•I 1 Capacity 1 V•Nul• <br /> Puntpar Vehicle t , <br /> Pumper Yard Package TreatmentNunb•r of Will.Plant Chemical Toilets , <br /> MEDICAL WASTE PROGRAM {4500} <br /> primary Care Acute Care Skilled Nursina Larne Generator <br /> Small Generator Transfer Station Limited Hauler Veterinary Clinic <br /> Common Storage Fec1111 1 2-10 generator. I 11 -60 g•neralon >60 g.n.r.tor. <br /> RECREATIONAL HEALTH PROGRAM {3600} <br /> Pool <br /> spa Out of Service Pool/spa Nat Ural Ba fill rig Area <br /> Nunb.r of Pou1N6p.• at Faolllty Pool/bps ID I <br /> SITE MITIGATION PROGRAM {2000} <br /> Environmental Assessment STICAP Local az We lfez Met Pi reline <br /> I C QCB 1 Cd EPA-DT6C / ^- i U6 EPA <br /> Other Lead Agency Site 1 <br /> 1 NPL Site 1 we"'Guallty a _l 1 other <br /> SOLID WASTE PROGRAM {4400} h <br /> rt rY . <br /> Landlill Transfer Station Aft/Cannery WasteSi PUBX11 AiH,a$ RVIC <br /> - IVl.crr <br /> CIA Landfill Site Sludge/Ash Site Compost Facility Refuse Vehlclee Nsnber or unit. <br /> Weete The Facilit Process/Recycle Faclllt Dum eters >20 cu yd <br /> Nhnjl et o1 urJt. <br /> VECTOR CONTROL PROGRAM {4000} i <br /> Poultry Farm M.x mmi Number of Blida . Kennel <br /> E,nerg.noy Nodllcadon lot tide FACIUTY and/or P110GRAM Day Night <br /> CONTACT PERSON: <br /> Daalgnatud Employee I Proptan t9hnMllt fill, Ntrhbor of tkdlr EPA ID 0 <br /> Ro,iolved by PatoI141VlQw$j by alb ffla are <br /> a <br />