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Sd COUNTY PHS-ENVIRONMENTAL HEALTH DIVISItr.,r MASTERFILE flE INFORMATION FORM{EH 00 59(a.d..d areal) <br /> New EH Program/New Facility Dete <br /> New FH Program/F-Aisting Facility 3 <br /> SHADED SECTIONS FOR LOCAL USE ONLY �y <br /> FACILITY ID # <br /> pRECORD ID # <br /> Please Mark the Appropriate Description and Specify Size and/or Number of Unite where epplioable: <br /> _DAMY PROGRAM {2000} ��� �- `�/" �� 71 <br /> G d ADd <br /> cmd.B Dairy Milk Di.p.On.r Number or Conteinen In Mulo-Mend Udt <br /> — FOOD PROGRAM {11600} <br /> 1 S..d.p C.P.dty I silo...F.bmg. Produce Stand Ice Plant <br /> Restaurant t <br /> Nunber of UMts <br /> p N I' Food P .mdu r V d- g Macnes <br /> hi <br /> C re v <br /> S F I -111,MOM Me,ket nit I will,Fnad Prepemdnn 1 Ory Oood.aMv <br /> Retail Market 1 <br /> I I Reganeeon# I Uoen.a# <br /> 1 Mnke 1 Vahlol.Type Col <br /> 1 or l 1 <br /> Food Vehicle l 1 <br /> 1 Meke 1 V.hid.Type Calor I Regi.n.don# U.ens.# <br /> Mobile Food Unit l 1 <br /> Te=F-.dF.c.lty Special EventD. m to D.t..of Op.r.t.. from <br /> Eiered <br /> HAZARDOUS WASTE PROGRAM {2200} <br /> I TOO.g.nernadous Waste GeneratorCaugod.dly ..,hod..d Cetellod.elly Exempt1 Parmlt by Rule <br /> Permit Facility 1 <br /> _HOUSING PROGRAM {2400} EMPLOYEE HOUSING {2700} <br /> 1 Number of Unit. Nmnbar of bnployae. Ddry Employee Ibu>Ing <br /> HotellMotel _ <br /> Approzimnta Dat.>Of OCOUPsn.y <br /> Jail or Exempt Institution tO <br /> `L10UID WASTE PROGRAM {4200} <br /> 1 R.pUtrntlon > 1 Ucense# I Capnelry 1 V.1,16.# <br /> Pum er Vehicle <br /> Number of ON" <br /> pumper Yard Package Treatment Plant Chemical Toilets 1 <br /> MEDICAL WASTE PROGRAM {4500} <br /> Primer Care Acute Care Skill�Nursin Lar a GeneratorSmall Generator Transfer Station LimiVeterinary Clinic <br /> EJ <br /> 1 2-10 ganar.ton 11 -So g.n.r.mr. >60......mn <br /> Common Storage Facgit 1 <br /> RECREATIONAL HEALTH PROGRAM {3600} <br /> Pad Sl2a Out vcPool/s. Natural Bathina Area <br /> Nmnbar of Pools/Spee <br /> at F.0111y Pod/Spn ID# <br /> SITE MITIGATION PROGRAM {2900} <br /> Environmental Assessment USTICAP Local Haz Waste Haz Mat Pipeline <br /> I Cd EPA-RWOCB 1 CA EPA-DTSC I US-EPA <br /> Other Lead Agency Site <br /> 1 NPL Site 1 W.I.,Dudity Sit. 1 Otb.r <br /> SOLID WASTE PROGRAM {4400} <br /> rCIA <br /> fil Transfer Station A /Canner Waste Site <br /> Landfill Site Sludge/Ash Site Compost Facility �Dufmp.tr,euse VehiclesNumber or uNu <br /> Number of Unit> <br /> le Tire Sit <br /> Process/Rec cle Facilit e >20 cu Yj <br /> VECTOR CONTROL PROGRAM {4000} <br /> Maah.mn Nmnbar of Bird. Kennel <br /> PoWtry Farm <br /> Em.rg.O,14o011n.4°n far this FACWTY aMlor PROGRAM Day Nlgln <br /> CONTACT PERSON= <br /> Designated Employee# Progrmn Dement�• Currant Statue Number of Unib EPA ID R <br /> .parva y .1. .maws y nu l► . .tOObng me ate n t ee me nt iill .1. <br />