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EnvironmentalHealth
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EHD Program Facility Records by Street Name
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GRANT LINE
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1600 - Food Program
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PR0542506
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Entry Properties
Last modified
1/31/2023 3:26:56 PM
Creation date
4/29/2020 8:47:09 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0542506
PE
1633
FACILITY_ID
FA0024434
FACILITY_NAME
REYNA'S TAMALES
STREET_NUMBER
340
Direction
W
STREET_NAME
GRANT LINE
STREET_TYPE
RD
City
TRACY
Zip
95376
CURRENT_STATUS
01
SITE_LOCATION
340 W GRANT LINE RD
P_LOCATION
03
QC Status
Approved
Scanner
SJGOV\jcastaneda
Tags
EHD - Public
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SAN JOAQUIN COUNTY E RONMENTAL HEALTH DEPAR :NT <br /> MASTERFILE RECORD INFORMATION FORM q�Ao�A, <br /> ❑ New EH Program at Existing Facility 1ZNew EH Program and New Facility <br /> Facility ID O(72. 3 Program Record ID 1�RDcS ��� �•4/�/ �® <br /> Facility Address 3qo kA) (�rcA/,yA - I y�� 1�-cuk (�_S3Z,6 s N�qX418 <br /> (Please check the appr)appropriate description and specify size, number of units and pertinent information.) y�9(Ty� q F�p�N�y <br /> FOOD PROGRAM 1600 �n <br /> ❑ Restaurant: Seating Capacity Square Footage Food Handlers Course required: YES ❑ 'IR�i/�1 <br /> .0 Commissary ❑ Dry storage only ❑ with Food Preparation ❑Vending Machines Number of Units <br /> 0 Retail Market----Square footage ❑ w/Meat Market only ❑ Multiple Departments ❑ Prepackaged Goods Only <br /> ❑ Mobile Food Vehicle--Make Vehicle Type Color <br /> Registration# License# 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 /> ❑ CalARP 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 Units <br /> SOLID WASTE PROGRAM (4400) <br /> ❑ Landfill ❑ Transfer Station ❑ Ag/Cannery Waste Site ❑ Sludge/Ash Site <br /> ❑ Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Facility ❑ CIA Landfill Site <br /> ❑ Refuse Vehicles (#or Units) ❑ Dumpsters>20 cu yd (#of Units) ❑ Farm/Ranch Cleanup Site <br /> MEDICAL WASTE PROGRAM (4500) <br /> ❑ Primary Care ❑ Acute Care ❑ Skilled Nursing ❑ Large Generator ❑ Small Generator ❑ Limited Hauler <br /> ❑ Transfer Station ❑ Veterinary Clinic ❑ Common Storage Facility ❑ 2- 10 ❑ 11 -60 ❑ >60 generators <br /> PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Application Form <br /> EMERGENCY NOTI ICATION FOR THIS FACILITY AND/OR PROGRAM <br /> CONTACT PERSON flit— li-� -4A Day Ph 3- Night Ph Z ( - (j ;3 <br /> PROGRAM ELEMENT FEE ❑ Surchar e F E El Other FEE <br /> INSPECTOR# A ( PERMIT VALID I I j to ❑ Food Handler <br /> ElCheck# AMOUNT PAID •�� Date INVOICE# q.4 <br /> Cash REVIEWED BY ACCOUNTING OFFICE Date <br /> 48-b2-034 MASTERFILE KECOIRD INFORMATION PINK <br /> 1/23/13 <br />
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