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EHD Program Facility Records by Street Name
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UNION
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26234
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4700 - Waste Tire Program
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PR0535070
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Entry Properties
Last modified
5/26/2020 3:18:11 PM
Creation date
5/26/2020 2:51:38 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4700 - Waste Tire Program
File Section
BILLING
RECORD_ID
PR0535070
PE
4740
FACILITY_ID
FA0003343
FACILITY_NAME
BRASIL, F AND S DAIRY #1
STREET_NUMBER
26234
Direction
S
STREET_NAME
UNION
STREET_TYPE
RD
City
MANTECA
Zip
95337
APN
25712002
CURRENT_STATUS
02
SITE_LOCATION
26234 S UNION RD
P_LOCATION
99
P_DISTRICT
005
QC Status
Approved
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CField
Tags
EHD - Public
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1 <br /> SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTIi DEPARTMENT <br /> MASTERFILE RECORD INFORMATION FORM <br /> [&New EH Program at Existing Facility []New EH Program and New Facility <br /> Facilit•ID FA OgQ3 Pro ram Record ID PAC-53 0-� <br /> Facility Address - S uni fin 0-1 I )LiJl�erra , (� 8533'] <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 IIandlers Course required: Yes❑ NO ❑ <br /> ❑ Commissary ❑ Dry storage only ❑ with Food Preparation ❑Wending Machines—Number of Units <br /> ❑ Retail Market—Square footage ❑with 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 <br /> ❑ Special Event —Dates of operation from to ❑ Produce Stand <br /> DAIRY PROGRAM(2000) <br /> ❑ Grade A Dairy ❑ Grade B Dairy ❑ Milk Dispenser—Numbcr of Containers in Multi-Head Unit <br /> CUPA ❑ State Facility Surcharge(2399) <br /> IIAZARDOUS WASTE PROGRAM(2200) <br /> ❑ hazardous Waste Generator-- Tons Generated Per Year ❑ Recycle/Eaempt System(2299) <br /> ❑ CRT Offsite Handlers(2218) ❑ Silver Only(2222) _ ❑ Appliance Reeyclers(2217) <br /> Tiered Permitting Facility ❑ Conditionally Authorized(CA) ❑ Conditionally Exempt(CE) <br /> ❑Pemut-By-Rule Fixed Unit ❑Permit-By-Rule Household Hazardous Waste <br /> ❑ ABOVEGROUND STORAGE TANK FACILITY(AST)(2390) Number of AST <br /> UNDERGROUND STORAGE TANK(UST)PROGRAM(2300)Use UST A and.B forms <br /> HOUSING PROGRAM(2400) <br /> ❑ notel/htotel Number of Units ❑Jail or Exempt Institution Number of Units <br /> Employee housing(2700)Use Fmployee Housin&Tabor Camp Application Form <br /> SITE MITIGATION(2900) UNDERGROUND INJECTION CONTROL(3000) <br /> 11Environmental Assessment ❑ UST-CAP Site ElLocal MV Cleanup Site. ❑ NPLJSEP Cleanup Site El UIC Site <br /> ❑ Abandoned IIW Site ❑ non-NPLJSEP Cleanup Site ❑RIVQCB 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 /> El Poultry Farm Maximum number of birds 11 Kennel <br /> TATTOO BODY PIERCING PERMANENT COSMETIC PROGRAM(4100) <br /> ❑ Tattooing(4121) ❑ Body Piercing(4120) ❑ Permanent Cosmetics(4122) <br /> LIQUID WASTE PROGRAM(4200) <br /> El Pumper Vehicle—Registration# License# Capacity Vehicle# <br /> ❑ Pumper Yard ❑ Package Treatment Plant ❑ Chemical Toilets Number of Units <br /> SOLID WASTE PROGRAM(4400) <br /> 11 Landfill 11 Transfer Station 1:1 Ag/Cannery\Waste Site ❑ Sludge/Ash Site <br /> IX Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Facility ❑ CIA Landfill Site <br /> ❑ Refuse Vehicles—Number of Units ❑ Dumpsters>20 cu yd--Number of Units ❑ Farm/Rauch 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--11 2- 10 ❑ 11 -60--❑>60 generators <br /> PUBLIC WATER SYSTEM PROGRAM(4600) Use PHIS BlfD 46-02-003 Blue Application Fomr <br /> EMERGENCY NOTIFICATION FORTHIs FACILITY AND/OR PROGRAM <br /> CONTACT PERSON Day Ph Night Ph <br /> i <br /> PROGRANI ELEMENT LMA0 FEE ❑ Surcharge FEE ❑ Other FEE <br /> INSPECTOR# PE-RMITVALID . to ❑ Food Handler <br /> ❑ Check A-TAOUNT PAID Date INVOICE# <br /> ❑ Cash REVIEWED BY N��+1�ID ACCOUNTING OFFICE �� Date `/ . ! L <br />
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