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BILLING_2019
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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CALIFORNIA
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1600 - Food Program
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PR0544718
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BILLING_2019
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Entry Properties
Last modified
4/9/2020 10:04:21 AM
Creation date
4/9/2020 10:01:28 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2019
RECORD_ID
PR0544718
PE
1635
FACILITY_ID
FA0025415
FACILITY_NAME
MARISCOS Y TACOS SINALOENSE #00529U2
STREET_NUMBER
730
Direction
S
STREET_NAME
CALIFORNIA
STREET_TYPE
ST
City
STOCKTON
Zip
95206
APN
14723003
CURRENT_STATUS
01
SITE_LOCATION
730 S CALIFORNIA ST
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
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Tags
EHD - Public
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SAN JOAQUIN COUNTY E ,RONMENTAL HEALTH DEPAR'. :NT <br /> MASTERFILE RECORD INFORMATION FORM <br /> ❑ New EH Program at Existing Fa_ility ❑New EH Program and New Facility <br /> Facilit ID ' 1.Y�2 / Pro ram Record ID kD571 <br /> Facility Address T'50 fe�_ hf - r,W—t •-i <br /> (Please check the appropriate description and specify size, number of units and pertinent information.) <br /> FOOD PROGRAM(1600) <br /> ❑ Restaurant: Seating Capacity Square Footage Food Handlers Course required: YES ❑ No ❑ <br /> ❑ Commissary ❑ Dry storage only ❑ with Food Preparation ❑Vending Machines Number of Units <br /> ❑ Retail Market----Square footage ❑ w/Meat Market only ❑ Multiple Departments❑ Prepackaged Goods Only <br /> Mobile Food Vehicle--Make Vehicle Type — Color <br /> Registration# License# 0O`�.G j LA s-- Sticker# <br /> ❑ Mobile Food Prep Unit--Make Vehicle Type Color <br /> Registration# License# Sticker# <br /> ❑ Temporary Food Facility--Dates of operation from to ❑ Ice Plant❑ Produce Stand <br /> ❑ Special Event---Dates of operation from to ❑ CFO ❑ A ❑ B <br /> DAIRY PROGRAM (2000) <br /> ❑ Grade A Dairy ❑ Grade B Dairy ❑ Milk Dispenser-Number of Containers in Multi-Head Unit <br /> CUPA <br /> ❑ Hazardous Materials Business Plan (1900) Number of chemicals: <br /> ❑ CaIARP Program ❑ Program 1 Facility ❑ Program 2 Facility ❑ Program 3 Facility <br /> ❑ Hazardous Waste Generator(2200)----------> Tons Generated Per Year <br /> ❑ Tiered Permitting Facility-------> ❑ CA(2232) ❑ CE (2233, 2234, 2235, 2237) ❑ PBR (2231) ❑ PBR HHW(2236) <br /> ❑ Aboveground Storage Tank Facility (AST) (2800) Number of ASTs <br /> ❑ Underground Storage Tank Program (UST) (2300) Use UST A and B forms <br /> ❑ Other CUPA Program <br /> HOUSING PROGRAM (2400) <br /> ❑ Hotel/Motel------Number of Units ❑ Jail or Exempt Institution ----Number of Units <br /> Employee Housing (2700) Use Employee Housing/Labor Camp Application Form <br /> SITE MITIGATION (2900) UNDERGROUND INJECTION CONTROL(3000) <br /> ❑ Environmental Assessment ❑ UST-CAP Site ❑ Local HW Cleanup Site ❑ NPL/SEP Cleanup Site ❑ UIC Site <br /> ❑ Abandoned HW Site ❑ non-NPL/SEP Cleanup Site ❑ RWQCB Cleanup Site ❑ Water Quality Remediation Site <br /> RECREATIONAL HEALTH PROGRAM (3600) <br /> Number of Pools/Spas at Facility ❑ Pool ❑ Spa ❑ Out of Service Pool/Spa ❑ Natural Bathing Area <br /> VECTOR CONTROL PROGRAM(4000) <br /> ❑ Poultry Farm-------Maximum number of birds ❑ Kennel <br /> TATTOO, BODY PIERCING,PERMANENT COSMETIC PROGRAM (4100) <br /> ❑ Body Art Practitioner Reg (4110) ❑ Mechanical DSPS Notification (4115) ❑ Body Art Facility-Single Use (4120) <br /> ❑ Body Art Facility-Sterilization (4121) ❑ Body Art Temp Event Co-ord (4130) ❑ Body Art-Temp Event Mobile Facility(4131) <br /> LIQUID WASTE PROGRAM(4200) <br /> ❑ Pumper Vehicle Registration# License# Capacity Vehicle# <br /> ❑ Pumper Yard ❑ Package Treatment Plant ❑ Chemical Toilets----Number of UniP <br /> SOLID WASTE PROGRAM(4400) R <br /> ❑ Landfill ❑ Transfer Station ❑ Ag/Cannery Waste Site ElSludge/9sgd(w; <br /> ❑ Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Facility ❑ CIy&ff Ini Site <br /> El Refuse Vehicles (#of Units) ElDumpsters> 20 cu yd (#of Units) Farm/Ra11 QV6up Site <br /> SMJMEDICAL WASTE PROGRAM (4500) EFNV AQ <br /> CO <br /> El Primary Care 11 Acute Care El Skilled Nursing [3 Large Generator ❑ Small Gen�fftr.. 4PP iter <br /> El Transfer Station 13 Veterinary Clinic ❑ Common Storage Facility ❑ 2 - 10 ❑ 11 -60 PWyftrators <br /> PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Application Form <br /> //,,, EMERGENCY NOTIFICATION FOR THIS FACILITY AND/OR PROGRAM <br /> CONTACT PERSON �I Cvl. DayPhjM.qjgq qib1 Night Ph " <br /> PROGRAM ELEMENT FEES ❑ Surcharge FEE ❑ Other FEE <br /> INSPECTOR# 3 ? I PERMIT VALID `7 [moo I "I to 2�3 I (' ❑ Food Handler// <br /> 13Check# {.�D AMOUNT PAID -!2,1 - Date -7 ( 30 11 INVOICE# 7 <br /> ❑ Cash REVIEWED BY ACCOUNTING OFFICE 6AL Date ;?� <br /> 48-02-034 MASTERFILE RECORD INFORMATION PINK <br /> 1/23/13 <br />
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