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Please provide all information requested , an incomplete application may delay approval <br /> ❑ FACILITY INFORMATION <br /> Name of Facility : WalMart # 1554 <br /> Street Address : 3223 E Hammer Ln <br /> City : Stockton Zip Code : 95212 <br /> ❑ FORMER NAME OF FACILITY <br /> ❑ BUSINESS OWNER INFORMATION <br /> Business Owner Name : WalMart Stores Inc . <br /> Home Address : <br /> Mailing Address : 2608 SE J Street Bentonville AR 72716 <br /> Telephone Number : 479 - 273 - 4000 <br /> ❑ PROPERTY OWNER INFORMATION <br /> Property Owner Name : WalMart RE Business Trust <br /> Home Address : <br /> Mailing Address : 2608 SE J Street , Bentonville , AR 72716 <br /> Telephone Number : 479 - 273 - 4000 <br /> ❑ CONTRACTOR INFORMATION <br /> Name of General Contractor : TBD <br /> Mailing Address : <br /> Telephone Number : <br /> Contact Person on Site : <br /> Site Phone Number : <br /> ❑ UTILITIES NA - Existing to remain , no change <br /> Source of Facility Water Supply : <br /> Backflow Protection : <br /> System to be used for Liquid Waste Disposal ( Sewage ) : <br /> Solid Waste Disposal to be provided : <br /> Grease Interceptor : <br /> ❑ FOOD INFORMATION NA - Existing to remain , no change <br /> List food ( s ) to be served and /or provide menu : <br /> ❑ OPERATIONAL INFORMATION NA - Existing to remain , no change <br /> Anticipated Business Hours : Open : Close : <br /> Anticipated Number of Employees : <br /> EHD 16-01 4 PLAN CHECK GUIDE <br /> 7/5/ 17 <br />