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t <br /> SAN JOAQUIN COUNTY I&NVIRONWNTAL HEALTH DEPARTMiNT <br /> MASTERFILE RECORIf-UMP 4AUON FOM <br /> D New F.li Pro at ELhgV6Fa Maw Eli Lwm and New Facility <br /> FaSM ID rftO;XZ bD k Lroffam Record IDP9053ql�7-9 :] . <br /> Facility Addrtss &' 207 <br /> (Please Check the appropriate d4saiptiou and specify f,number of na#ts*net ptdineat aformstion,) <br /> FOOD PROGRAM(1600) <br /> D Resuamnt: Seating Capac k Square Footage Food Handlers Course r aired-, YEs D N613 <br /> E3 commissm D Dry storage only D vft Food Pnpwation rwesi►diag MaAkm Number of Units <br /> 13 Rctait'Market--Square footage E3 with Meat Market only. D Muldipie Dgartmeats 0 hvacbged Hoods 0u1y <br /> D Mobgt Food veWde M*t Vebick Type Cola' <br /> Registration# Lice["# Sticker# <br /> E3 Mobile Food Pmp Unit–Make Velack Type Color <br /> g, #ion# License# Sticker# <br /> O Temporary Food FadItty-»–dam of operation #roti to O let Plant <br /> D Special Event Dates of operation from to E}Produce Shad ti <br /> DAIRY PROGRAM(2400) y <br /> _E3 Grade A Datxy D Gradt B Dairy D maDispeastr- lumbar of containers in Muter Head L'Inft— <br /> CUPA D Stitt Fat ttty Surch=Tt(2399) <br /> HAZARDOUS WA5'I'lg PROGRAM q2M` t <br /> O Iia=rdous Waste Generafor� -� -- Tons Coated BwYmr D Recyde IExtmpt Wem(2299) <br /> E3 CRT Offsite Handlers(2219) E3 Silver Only 0222) t E3 Appliance Recyclers(2217) <br /> Tiered Permitting k+`AVMty E3 Calot rally Authorized(CA) (3 Conditionally Extort(CE) <br /> D Peunit-Byatt:Fixed Unit D Peen it-By4 ule household Hazardous Waste <br /> E3 ABOVEGROUND STORAGE TAMC FACIIM(AST)(2394) Ntedxx of AST <br /> UNDERGROUND STORAGE TANK(UST)PROGRAM(2300)Ux fISI'A ags forms <br /> HOUMG PROGRM(2400) <br /> D RoteUMota----Nwbx of Units 13 Jag orExem pt Ins#ita Con----Noubar of Units <br /> Fawley"Hoasiot{2i00)�C�t.�O.'ee `1i n� r� tcatFmFotm <br /> SITE WMGATION(2900) UNDERGROUND 1NJECnR"COMMOL(3000) <br /> -D EnYironmantat Asstssm t E3 UST-C"Site •13 I.ecat uw Cleauap Slit. E3 NPLIS p Cteunp Site, 13 UIC Site <br /> D Abandoned MW Site E3 non-NPLmr peausp Site E3 RwQm Lknap Site -E3 wtter Quilty motion Sue* <br /> &qGREA"ONAL H L�'R H ,PROGRAM(3600) <br /> Numbir of PoolslSpas at Far ity. D Pnol E3 Spa C3 out of S"ct pooppa E3 Nafivat BathinjAm <br /> VECTOR GO OL PROGRAM(4000) <br /> D Poultry Firm-----WWdmucn tcum&r ofbuds D Kenud <br /> 8 DY.P C1NG N ME METtC PROGRAM(4100) <br /> Tattoaing(4121) E3 Body Piecing(4120) D Permanent Cosmetics(412.2) <br /> UIQUID WASTE PROGR K(4200) Vehicle# <br /> 13 Pampa vchick.-Itegzsbration# L tia�se# capacity <br /> E3 puma E3 D cktmitalToilets Number of Units <br /> SOLID W&M PROGRAM(4400) <br /> 13 Landfill E3 TransferStatloa E3 Ag!Canaerywnte Site D Sludge/Ask Site <br /> E3'waste Tire Fader D Compost Fadtity E3 ft*w Recycle Fadlity E3CIA <br /> E3 Rttme,Vdddes bcr 4 ofUnits E3 Dumpsias a 20 en yd----Number of Units E]Fa • a to <br /> )4 WICAL WASTE PROGRAM(4500) �., <br /> E3 Pdoul Cine ©Atate Care E3 Sidlled Narsing t3 Large Generator D Smau Geatrritor dfinQtii r <br /> D Transferstatbu O veterinary Ci'init D Common Storage Fidrq-----13 2.10—0,11 ftmtg, Mors <br /> PUBLC WARSYSIPROGRM(450)the-MB ENVIROECOUNTY) NTAL <br /> HEALTH DEPARTMENT <br /> - Y strtcnrtatt frt�R YIIts FACILITYr�ralotr 1'ROGltAM <br /> CONTACrPERSON �Dayph 70-7-Y �hgNightph <br /> PROGRAM EVAERr >sZ aft E1 Surcharre Fzz D ower FEE <br /> Irrssr # PERMtT YALro I s c5 to so /5" E3 Food Handler <br /> c2 ata A14soUnPAIP CQ Date l SlI S DWOIM# 25$3fvc� <br /> cast+ RBVWW3W`8Y A�ori Date S S <br /> • �• ULderCtle Record Fink <br />