Laserfiche WebLink
SJ COUNTY PHS-ENVIRONMENTAL HEALTH DIVIS' MASTERFILE Rr 4D INFORMATION FORM {EH 00 691Rem..d 61941} <br /> 11 New EH Program/Existing Facility New EH Program/New Facility Data <br /> SHADED SECT/ONS FOR LOCAL USE ONLYEl <br /> FACILITY ID # GOT RECORD ID # <br /> Please Mark the Appropriate Description and Specify Size and/or Number of Unite where applicable: <br /> DAIRY PROGRAM {2000} J ; - c-.. � <br /> Grade A Dem, Grade B Dalry Milk IN....... Number of C.mainan In Multi-Head Uri, <br /> FOOD PROGRAM {1 BOO} <br /> Restaurant 1 Se.Snq C....iw t Squ.,.Foot... Produce Stand Ice Plant <br /> 1 Ory S.o.u.only I with Food Prepu.don Numb-or Urit. <br /> Commissar Vendin Machines <br /> Retail Markel I Sarram Foomp. 1 with Meet M.rku oMy I eiltb Food Prepar.tlon 1 Dry Goods oriY <br /> l <br /> Food Vehicle Make 1 VAAM.Type 1 CA., f Red.tradon a 1 Us.m.s <br /> 1 1 1 f 1 <br /> 1 Make l Vehlete Type 1 ca., 1 Regi.tretlon R 1 U.en.e N <br /> Mobile Food Unit 1 l l 1 1 <br /> I <br /> Temporary Food Facility I Special Event <br /> DA..of opemtlon from to Dam.of Opem,ion tram tp <br /> HAZARDOUS WASTE PROGRAM {2200} <br /> v. <br /> Hazardous Waste Generator 1 Tom n.mred par.... <br /> Tiered Permit Facilityi camvodaWly .umodzed Categorically Exempt1 Permit by Bu s <br /> HOUSING PROGRAM {2400} EMPLOYEE HOUSING {2700} <br /> Hotel Motel <br /> I Number of Unit. Numbar of Employee. Ds"Employs Houdno <br /> Jail or Exempt Institution Appm.i—te Data.of 0...p.eoy ,p <br /> DQUID WASTE PROGRAM {4200} <br /> I Pum er Vehicle Regietretlon♦ 1 Ucen.. r I C.P.Mty r V.nicle e <br /> l <br /> Pumper Yard Package Treatment Plant Nunber of Unit.Chemical Toilets 1 <br /> MEDICAL WASTE PROGRAM {4500} <br /> Primary Care Acute Care Skilled Nursing Larne Generator <br /> Shall Generator Transfer Station Limited Hauler Veterinary Clinic <br /> Common Storage Facility t-to venerator. i t i �60 gen.mmr. i >60 c.e,r.tor. <br /> RECREATIONAL HEALTH PROGRAM {3600) <br /> Pool I Spa Out of Service Pool/Spa Natural Bathing Area <br /> Numbar of Pods/Spar,at F.d iry Podlsps ID A <br /> SITE MITIGATION PROGRAM {2900} <br /> Environmental Assessment USTICAP Local Haz Waste Hat Mat Pipeline <br /> Other Lead Agency Site l Cd EPA-RWGC8 1 Cal EDA-DTSC 1 USEPA <br /> I NPL Site I W.I.,Q-1i",Site 1 Oth.r <br /> SOLID WASTE PROGRAM {4400} <br /> Landfill Transfer Station Ag/Cannery Ag/CanneryWaste Site <br /> CIA Landfill Site Sludge/Ash Site Compost Facility Refuse Vehicles Nu-bar of unit. <br /> Waste Tire Facility Process/Rec cle Facility Dum stere >20 cu yd N°Taber.f wit. <br /> VECTOR CONTROL PROGRAM {4000} <br /> PoWvy Farm <br /> Merl ammn Nunb.r of Mode Kennel <br /> Dnergency Nmllkin1mm for Ili.FACILITY andlor PROGRAM Day NI.AI <br /> CONTACT PERSON] ( ) I ) <br /> E <br /> l.Yea R Progrmn EleCurrent Status Number of Uoll.ole ewewa y ate epoun nq m. nn er ata ae a� <br />