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S.I COWN1 Y PIIS -ENVIRONMENTAL I IFALI I I DIVISI' MASTFRFII E 111^"911 INFORMATION FORM {EII 00 60(8.v1..1 61941) <br /> New Ell PrograntlEalsting Facility Now Ell ProgramlNew Faoility I Ilnte <br /> S1IADED SECTIONS FOR LOCAL USE ONLY <br /> FACILIuj! VJV2 DM-) ECORt) ID # I <br /> Pleaas Math the Approprlele Dssorlptlon end Speolfy Siza and/or Number of Units where applionbls: <br /> DAIRY PROGRAM {2000} <br /> Grsd.A D.hy Gud.B D.Iry - Mllk 01.p.n..r — - Ntmb.f of Cont.hwo In Mold Hood Udt <br /> c <br /> FOOD PROGRAM {1600} ' <br /> 1 6.ndnp Capaolty I 6quar.Fool.d. <br /> fiestamant t 1 oduce 616 id Ice lout <br /> C011111119eafY Dry 61ora0•o,Jy i with Food P,.pnr.don Nunb., of U,41. <br /> �/endh� M11echlllee <br /> Fow.p. I with M..t Mmk.t.,Jy 1 with Fuod Pr.vn orlon I pry O—hr oily <br /> 1LS„n r•r�L`�1 1 1_ l 1 <br /> M.k. I VdJol. Typo I Cu1or 1 R691.1r.d.11 N I U.—.. I l <br /> Food Vehicle I I I 1 I I <br /> 1 1 1 I 1 11 <br /> M.k. I V.N.I.TYPO I C.1or I R.g1w.d.n I 1 llo.nu I <br /> Mobile Food Unit I I I 1 1 <br /> 1 1 I I 1 <br /> Tempar6ry Food Facility Speclai Event <br /> Datu of Op.tadon born to Det..of Op.r.don bon, to - <br /> HAZARDOUS WASTE PROGRAM {2200} <br /> 1lezenlous Waste Generator i <br /> I Ton.Q.n.uad pa toot <br /> I C.tsgorloolly 4110101124dd I C.1.p°d°ally E..mpl P.In,11 by Rd. <br /> Tiered Pennll Facility I <br /> HOUSING PROGRAM {2400} EMPLOYEE HOUSING {2700} <br /> -Alotel/Molef <br /> 1 Nunb.r of U.948 Nt.nb.r of 6drynpl°y... OEr n ploy.. Ilou.lrtg <br /> Jail or Exempt Institution Appru.bnu. D.t..of 000up..toy to <br /> LIQUID WASTE PROGRAM {4200} <br /> 1 R.gl.tt.don I I 11061'.. I I C.P.olty I V.hlul. <br /> Pumper Vehicle 1 1 1 1 <br /> jNtmb.r of UFJb <br /> Pumper Yerd Package Treatment Plant Chemical Toilete , <br /> MEDICAL WASTE PROGRAM {4500} <br /> Frljsjary Care Acute Care Skilled f4thein Large Generator <br /> Small Generator Transfer Station Limped Hauler Veterinary Clinic <br /> CommonStora a Facility I 2-10 D.n.r.tor. I 11 -60 p.n.utan I >Go 9m.nton <br /> RECREATIONAL HEALTH PROGRAM {3600} <br /> Pool q Ou!of service Pool/spa Natural Bathinil Area <br /> Nm,b.,of P-1./Sp.. at F.olllty <br /> SITE MITIGATION PROGRAM {2000} <br /> Envlronmental Assessment Sj(CAP Local Hez WatIftom Ilaz Met Pipeline <br /> Other Lead Agency Site Cs CB 1 Cal EPA-pT6C i UB EPA <br /> I NPL 611. I wa.r Oudlty 6 1 Otho <br /> _ SO(ID WASTE PROGRAM {4400} <br /> Q01JNTY <br /> Landfill Transfer Statin Ag/Cannery Waste SI FN ClaEAL7NSEE3VIC <br /> DIVISION Nunbsr of Unit. <br /> CIA Landfill Site Sludge/Ash Site Compost Facility Refuse Vehicles <br /> Weate Tke Fecllt ProceselRecycle Faclllt Dum eters >20 cu d Nt"ll 'or unll. <br /> VECTOR CONTROL PROGRAM {4000} 19- <br /> M..1 ton N—b.r of Blyd. <br /> poultry Ferro Kennel <br /> bnatpnuty Nodao.don lot dJ.FACILITY andlor PROGRAM Day (N Night <br /> CONTACT PERSON: '+ <br /> D.donatud 6111,I0yas I 7- Proptan gslnaU/ CurTNlt Stet IM Nufibsr OI UNIT EPA 10 J <br /> R000lved by Dole <br /> .v sws ld bv Dats oo()u " � �of j eN UN.1 Cleik ::Dolo t ( Ia -fSet• <br />