My WebLink
|
Help
|
About
|
Sign Out
Home
Browse
Search
BILLING
EnvironmentalHealth
>
EHD Program Facility Records by Street Name
>
A
>
AIRPORT
>
2440
>
1600 - Food Program
>
PR0544977
>
BILLING
Metadata
Thumbnails
Annotations
Entry Properties
Last modified
3/7/2024 11:35:50 AM
Creation date
2/11/2021 2:28:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
BILLING
RECORD_ID
PR0544977
PE
1635
FACILITY_ID
FA0025580
FACILITY_NAME
EL CERRITO #7S38432
STREET_NUMBER
2440
Direction
S
STREET_NAME
AIRPORT
STREET_TYPE
WAY
City
STOCKTON
Zip
95206
APN
16913327
CURRENT_STATUS
01
SITE_LOCATION
2440 S AIRPORT WAY
P_LOCATION
01
P_DISTRICT
001
QC Status
Approved
Scanner
SJGOV\ymoreno
Tags
EHD - Public
There are no annotations on this page.
Document management portal powered by Laserfiche WebLink 9 © 1998-2015
Laserfiche.
All rights reserved.
/
6
PDF
Print
Pages to print
Enter page numbers and/or page ranges separated by commas. For example, 1,3,5-12.
After downloading, print the document using a PDF reader (e.g. Adobe Reader).
View images
View plain text
SAN JOAQUIN COUNTY ENVIRONMENTAL HEALTH DEPARTMENT P A` <br /> MASTERFILE RECORD INFORMATION FORM elo <br /> ❑ New EH Program at Existin Facility ❑ R�CG.New EH Program and New Facilit iVIe® <br /> ® j <br /> Facilit ID Od ZSS Program Record ID �s CT 31 2419 <br /> Facility Address `'i''ld S- AIrpoeF `���'-J Gtk,,--� � S2� ", VORQUINCO(jly <br /> (Please check the appropriate description and specify size, number of units and pertinent information.) H'LTHDEpARTME�1 y <br /> FOOD PROGRAM(1600) <br /> ❑ Restaurant: Seating Capacity Square Footage Food Handlers Course required: YES ❑ No ❑ <br /> ❑ Commissary ❑ Dry storage only ❑ with Food Preparation ❑Vending Machines Number of Units <br /> ❑ Retail Market----Square footage ❑ w/Meat Market only ❑ Multiple Departments❑ Prepackaged Goods Only <br /> Mobile Food Vehicle--Make Vehicle Type Color <br /> Registration# License# 15 3ALA3"L 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❑ Produce Stand <br /> ❑ Special Event---Dates of operation from to ❑ CFO ❑ A ❑ B <br /> DAIRY PROGRAM (2000) <br /> ❑ Grade A Dairy ❑ Grade B Dairy ❑ Milk Dispenser-Number of Containers in Multi-Head Unit <br /> CUPA <br /> ❑ Hazardous Materials Business Plan(1900) Number of chemicals: <br /> ❑ CaIARP Program ❑ Program 1 Facility ❑ Program 2 Facility ❑ Program 3 Facility <br /> ❑ Hazardous Waste Generator(2200)---------->-Tons Generated Per Year <br /> ❑ Tiered Permitting Facility-------> ❑ CA(2232) ❑ CE(2233, 2234, 2235, 2237) ❑ PBR(2231) ❑ PBR HHW(2236) <br /> ❑ Aboveground Storage Tank Facility(AST) (2800) Number of ASTs <br /> ❑ Underground Storage Tank Program (UST)(2300) Use UST A and B forms <br /> ❑ Other CUPA Program <br /> HOUSING PROGRAM(2400) <br /> ❑ Hotel/Motel------Number of Units ❑ Jail or Exempt Institution ----Number of Units <br /> Employee Housing(2700) Use Employee Housing/Labor Camp Application Form <br /> SITE MITIGATION(2900) UNDERGROUND INJECTION CONTROL(3000) <br /> ❑ Environmental Assessment ❑ UST-CAP Site ❑ Local HW Cleanup Site ❑ NPL/SEP Cleanup Site ❑ UIC Site <br /> ❑ Abandoned HW Site ❑ non-NPL/SEP Cleanup Site ❑ RWQCB Cleanup Site ❑ Water Quality Remediation Site <br /> RECREATIONAL HEALTH PROGRAM(3600) <br /> Number of Poois/Spas at Facility ❑ Pool ❑ Spa ❑ Out of Service Pool/Spa ❑ Natural Bathing Area <br /> VECTOR CONTROL PROGRAM(4000) <br /> ❑ Poultry Farm-------Maximum number of birds ❑ Kennel <br /> TATTOO,BODY PIERCING,PERMANENT COSMETIC PROGRAM (4100) <br /> ❑ Body Art Practitioner Reg (4110) ❑ Mechanical DSPS Notification (4115) ❑ Body Art Facility-Single Use(4120) <br /> ❑ Body Art Facility-Sterilization (4121) ❑ Body Art Temp Event Co-ord (4130) ❑ Body Art-Temp Event Mobile Facility(4131) <br /> LIQUID WASTE PROGRAM(4200) <br /> ❑ Pumper Vehicle Registration# License# Capacity Vehicle# <br /> ❑ Pumper Yard ❑ Package Treatment Plant ❑ Chemical Toilets----Number of Units <br /> SOLID WASTE PROGRAM(4400) <br /> ❑ Landfill ❑ Transfer Station ❑ Ag/Cannery Waste Site ❑ Sludge/Ash Site <br /> ❑ Waste Tire Facility ❑ Compost Facility ❑ Process/Recycle Facility ❑ CIA Landfill Site <br /> ❑ Refuse Vehicles(#of Units) ❑ Dumpsters>20 cu yd(#of Units) ❑ Farm/Ranch 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 ❑ 2-10 ❑ 11 -60 ❑ >60 generators <br /> PUBLIC WATER SYSTEM PROGRAM (4600) Use PWS EHD 46-02-003 Blue Application Form <br /> E ERGENCY NOTIFICATION FOR THIS FACILITY AND/OR PROGRAM <br /> CONTACT PERSON 1Mill. Wff� Day Ph5(�, -uUL7 Night Ph l��2�S-y� 2 <br /> PROGRAM ELEMENT FEEyy2 ❑ Surcharge FE El Other FEE <br /> INSPECTOR# PERMITVALID v to ! 31 2 11Food Handler <br /> 1:1Check# AMOUNT PAI U Date INVOICE# <br /> Cash REVIEWED BY ACCOUNTING OFFICE Date <br /> 8-02-034 MASTERFILE RECORID INFORMATION PINK <br /> 1/23/13 <br />
The URL can be used to link to this page
Your browser does not support the video tag.