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Please provide all information requested; an incomplete application may delay approval <br />❑ FACILITY INFORMATION - - - - <br />Name of Facility: ARCO AM/PM Trinity Parkway Stockton <br />Street Address: 10715 Trinity Parkway <br />City: Stockton Zip Code: 95219 <br />❑ FORMER NAME OF FACILITY <br />NIA, new construction <br />❑ BUSINESS OWNER INFORMATION <br />Business Owner Name: Ken Dharni <br />Home Address: 6698 Mack Road, Sacramento, CA 95821 <br />Mailing Address: Same <br />Telephone Number: (916) 715-6425 <br />❑ PROPERTY OWNER INFORMATION <br />Property Owner Name: Same as Business Owner <br />Home Address: <br />Mailing Address: <br />Telephone Number: <br />❑ CONTRACTOR INFORMATION <br />3 <br />Name of General Contractor: Town and Country Contractors <br />Mailing Address: 3181 Luyung Dr. #A, Rancho Cordova, CA 95742 <br />Telephone Number: (916) 636-9500 <br />Contact Person on Site: TBD <br />Site Phone Number: TBD <br />❑UTILITIES --- <br />Source of Facility Water Supply: Cityof Stockton Municipal Utilities water service <br />Backflow Protection: Yes, for both domestic and irrigation lines <br />System to be used for Liquid Waste Disposal (Sewage): City of Stockton Municipal Utilities sewer service <br />Solid Waste Disposal to be provided: Republic Services <br />Grease Interceptor: None <br />❑ FOOD INFORMATION <br />List foods to be served and/or provide menu: <br />See attached menu <br />❑ OPERATIONAL INFORMATION <br />Anticipated Business Hours: Open: ARCO 7 days/24 hr Close: <br />Anticipated Number of Employees: ARCO: 8 to 12 <br />EHD 16-01 4 PLAN CHECK GUIDE <br />811114 <br />