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Please provide all information requested; an incomplete application may delay approval <br /> Name of Facility:Store#6187 <br /> Street Address:2705 Country Club Blvd <br /> City: Stockton Zip Code:95204 <br /> Business Owner Name:Western Refining Retail, LLC <br /> Home Address:19100 Ridgewood Parkway,San Antonio, TX 78259 <br /> Mailing Address:19100 Ridgewood Parkway,San Antonio,TX 78259 <br /> Telephone Number:For this project:661-250-9300 <br /> ❑ PROPE NER' <br /> Property Owner Name:Tesoro Sierra Properties LLC <br /> Home Address:19100 Ridgewood Parkway, San Antonio, TX 78259 <br /> Mailing Address:19100 Ridgewood Parkway, San Antonio, TX 78259 <br /> Telephone Number:For this project:661-250-9300 <br /> Name of General Contractor:Perry Builders <br /> Mailing Address:12405 Lockley Lane,Auburn,CA 95602 <br /> Telephone Number:For this project:661-250-9300 <br /> Contact Person on Site:For this project:A&S Engineering/Abigail Jara <br /> Site Phone Number:For this project:661-250-9300 <br /> Source of Facility Water Supply:Existing to remain <br /> Backflow Protection:Existing to remain <br /> System to be used for Liquid Waste Disposal (Sewage):Existing to remain <br /> Solid Waste Disposal to be provided:Existing to remain <br /> Grease Interceptor:Existing to remain <br /> List food(s) to be served and/or provide menu: <br /> Prepackage foods. <br /> Anticipated Business Hours: Exiongtommain Open: Close: <br /> Anticipated Number of Employees:Existing to remain <br /> EHD 16-01 4 PLAN CHECK GUIDE <br /> 7/5/17 <br />