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§iJ COUNTY PHS •WVIRONMENTAL HEALTH DIVISION MASTEFiFILE RECORD INFORMATION FORM{EH 00 991Re.i.ed sisal} <br /> 11 New EH Program/ExistiNaw EH Noorern/New Facility Dete <br /> SHADED SECTIONS FOR LOCAL USE ONLY <br /> FACILITY ID # 11 RECORD ID # <br /> Please Mark the Appropriate Description and Specify Size and/or Number of Units where applicable: <br /> _ DAIRY PROGRAM {2000} <br /> Giltde A Ddry Cr^de B 0, Milk Dhissis r Niarber of Contain—In MUIa A.M UNt <br /> FOOD PROGRAM {1 600} <br /> Senting Cna^city I Sose.F....o. <br /> Restaurant Produce Stand Ice Plant <br /> 1 Ory S...^.In .NY I wily Fng1 Pr.anrn�ion N�.nbe.of UNI. <br /> Commissar Vending Machines <br /> S.Imm� fn..mae 1 witl�Menl Mw.knt nwv with Frroa Pr+on.nUan I pn Cooa.oNv <br /> Retail Nk t Ili <br /> Mwk• 1 VeNd.iron cdo. R.O.nnaon f I Ua.m. r <br /> Food Vehicle I 1 I I <br /> i <br /> I MN.. I V,Neb Tvn+ I Cdnr 1 ReP.v^eon f I U<.nw l <br /> Mobile Food Unit 1 1 1 1 <br /> Temporary Food Facility Special Event <br /> Dates at on.,eaon aero ro p•oe or DP•.amn I,am m <br /> _ HAZARDOUS WASTE PROGRAM {2200} <br /> I r••r _ _ <br /> Hazardous Waste Generator Tom.......so Par <br /> Tiered Permit Facility Ye S sQTi Cet.gadadlr +mlwdaw C......mNlr Ex.nPt P.—t,'RN. <br /> _ HOUSING PROGRAM {2400} EMPLOYEE HOUSING {2700} <br /> 1 Nvnbar or UNtf N—b.,ar Enoloyeee p—6ngar.. NPunnV <br /> Hotel/Motel <br /> Aooro.bn.te p.m el obcuP.ncy <br /> Jail or Exempt Institution la <br /> _ LIOUID WASTE PROGRAM {4200} <br /> R-111,100" f Uc.n.w f 1 C.iisaw 1 Va....f <br /> Pumper Vehicle <br /> Pumper Yard Packa a Treatment Plant Chemical Toilets 1 nl.nbe.or unn, <br /> MEDICAL WASTE PROGRAM {4500} <br /> Primary Care Acute Care Skilled Nursinit Large Generator <br /> Shall Generator Transfer Station Limited Hauler Veterinary Clinic <br /> ]-10 esmr.mre t t .6o a.m.emn >6D g.mrmon <br /> Common Storage Facility <br /> RECREATIONAL HEALTH PROGRAM {3600} <br /> Pool Spa Out of Service Ficial/Spis Natural Bathing Area <br /> NUmbe,or Peoblso... nl Feciliry Podlope 10 A _ <br /> _ SITE MrnGAT10N PROGRAM {2900} <br /> Environmental Assessment UST/CAP Local Haz Waste Hat Mat Pipeline <br /> I Cd EPA-RWOCB 1 Cd EPA-OTSC 1 US-EPA <br /> Other Lead Agency Site <br /> I <br /> NPL Slb I Wnur pudlry Sita 1 on., i <br /> SOLID WASTE PROGRAM {4400} <br /> i <br /> Landfill Transfer Station Aq/Cannery A /CanneryWaste Site <br /> CIA Landfill Site Sludge/Ash Site Compost Facility Refuse Vehicles Nunb.r.1 U.I. <br /> I <br /> N..nb.r or uNl. <br /> Waste Tire Faeilit Process/Recycle Facility__ Dum stars >20 cu yd <br /> VECTOR CONTROL PROGRAM {4000} <br /> Poultry Farm <br /> .—--.,—bar or cam V, Kennel <br /> &—a—, NnUllcnnan lo,IIJ.FACIUTY nna/a.PROGRAM <br /> CONTACT PERSON= <br /> Deag..ned bnvloy.e E Progra n 9e.nem A - Cwwnr stars Number of UNb �� FPA 101 <br /> aecnwea br pme ' Reviewed by mn cawmanp w t a eu nt r. ep <br /> n I 3Iy 11648, <br /> LP <br /> COYV� 1 I - <br />