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BILLING_2018
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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ENTERPRISE
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385
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1600 - Food Program
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PR0543378
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BILLING_2018
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Entry Properties
Last modified
4/23/2020 12:54:52 PM
Creation date
4/23/2020 12:54:21 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
FileName_PostFix
2018
RECORD_ID
PR0543378
PE
1633
FACILITY_ID
FA0024634
FACILITY_NAME
SNOWIE NORCAL
STREET_NUMBER
385
STREET_NAME
ENTERPRISE
STREET_TYPE
PL
City
TRACY
Zip
95304
CURRENT_STATUS
01
SITE_LOCATION
385 ENTERPRISE PL
P_LOCATION
03
QC Status
Approved
Scanner
SShih
Tags
EHD - Public
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SAN JOAQUIN COUNTY E 'RONMENTAL HEALTH DEPAR7 'NT <br />MASTERFILE RECORD INFORMATION FORM <br />New EH Program at Existing Facility ONew EH Program and New Facility <br />PL33-75- <br />MAY i 1 2018 Facility ID PA 00,2_4 (S Program Record ID <br />Facility Address a 95 Lrykei-pn's(-3- Pl -ac t., ,\\,--c- , \cl.s.,.cis--481tATVougcouivrv <br />(Please check the appropriate description and specify size, number of units and pc ent information.) HEAcrpigNmEtvrAL - -PART/14E <br />FOOD PROGRAM (1600) <br />1a <br />Restaurant: Seating Capacity Square Footage Food Handlers Course required: YES p No CI <br />1=1 Commissary CI Dry storage only 0 with Food Preparation <br />Retail Market----Square footage 0 w/Meat Market only 0 Multiple Departments 0 Prepackaged Good Only , <br />)0 Mobile Food Vehicle --Make-...,v---f.._-\...::-% e__ Vehicle Type (7---k \C) / Color LAD % Yvv-it-l-k _ <br />Registration # License # Sticker # is-73 <br />Mobile Food Prep Unit-- Make Vehicle Type Color <br />Registration # License # Sticker # <br />Temporary Food Facility --Dates of operation from to 0 Ice Plant CI Produce Stand <br />CI Special Event---Dates of operation from to CI CFO 0 A CI B <br />PAymeNr <br />1?ecentto <br />OVending Machines Number of Units <br />DAIRY PROGRAM (2000) <br />Grade A Dairy CI Grade B Dairy CI Milk Dispenser-Number of Containers in Multi-Head Unit <br />CU PA <br />CI Hazardous Materials Business Plan (1900) Number of chemicals: <br />El CalARP Program CI Program 1 Facility CI Program 2 Facility CI Program 3 Facility <br />CI Hazardous Waste Generator (2200) > Tons Generated Per Year <br />Tiered Permitting Facility > 0 CA (2232) CI CE (2233, 2234, 2235, 2237) CI PBR (2231) CI 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 />CI Other CUPA Program <br />HOUSING PROGRAM (2400) <br />CI Hotel/Motel Number of Units 0 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 />CI Environmental Assessment CI UST-CAP Site CI Local HW Cleanup Site 0 NPL/SEP Cleanup Site CI UIC Site <br />Abandoned HW Site CI non-NPL/SEP Cleanup Site CI RWQCB Cleanup Site 0 Water Quality Remediation Site <br />RECREATIONAL HEALTH PROGRAM (3600) <br />Number of Pools/Spas at Facility CI Pool 0 Spa CI Out of Service Pool/Spa CI Natural Bathing Area <br />VECTOR CONTROL PROGRAM (4000) <br />CI Poultry Farm Maximum number of birds CI Kennel <br />TATTOO, BODY PIERCING, PERMANENT COSMETIC PROGRAM (4100) <br />CI Body Art Practitioner Reg (4110) 0 Mechanical DSPS Notification (4115) CI Body Art Facility-Single Use (4120) <br />CI Body Art Facility-Sterilization (4121) CI Body Art Temp Event Co-ord (4130) 0 Body Art-Temp Event Mobile Facility (4131) <br />LIQUID WASTE PROGRAM (4200) <br />Pumper Vehicle Registration # License # Capacity Vehicle # <br />CI Pumper Yard Cl Package Treatment Plant 0 Chemical Toilets ----Number of Units <br />SOLID WASTE PROGRAM (4400) <br />Cl Landfill CI Transfer Station El Ag/Cannery Waste Site 0 Sludge/Ash Site <br />Waste Tire Facility CI Compost Facility CI Process/Recycle Facility 0 CIA Landfill Site <br />CI Refuse Vehicles (# of Units) El Dumpsters > 20 cu yd (# of Units) 0 Farm/Ranch Cleanup Site <br />MEDICAL WASTE PROGRAM (4500) <br />CI Primary Care 0 Acute Care CI Skilled Nursing CI Large Generator 0 Small Generator 0 Limited Hauler <br />Transfer Station CI Veterinary Clinic 0 Common Storage Facility CI 2 - 10 0 11 - 60 0 > 60 generators <br />PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Application Form <br />EMERGE ICY NOTIFICATION FOR THIS FACILITY AND/OR PROGRAM (1-2)243)44 -StN3CD1-3 <br />CONTACT PERSON \C )---\(`C"- Day Ph b Night Ph CcD-S-C:Ft{czef-C1')-4 <br />PROGRAM ELEMENT Or 3-z.) FEE i •• CI Surchar e FE CI Other FEE <br />INSPECTOR # PERMIT VALID iff f .. <br /> <br />. to / 3 <br />CI Check # AMOUNT PAID WAN a) Date <br />Cash REVIEWED E.Y----- r)y.' -- ACCOUNTING OFFICE <br />4-02-034 <br />1/23/13 <br />0 Food Handler <br />INvoicE# C-2 7 ?6 <br />Date <br />MASTERFILE RECORD INFORMATION PINK
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