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<br />EHD 16-01 4 PLAN CHECK GUIDE <br />7/5/17 <br />Please provide all information requested; an incomplete application may delay approval <br /> <br />† FACILITY INFORMATION <br /> Name of Facility: <br /> Street Address: <br /> City: Zip Code: <br /> † FORMER NAME OF FACILITY <br /> <br />† BUSINESS OWNER INFORMATION <br /> Business Owner Name: <br /> Home Address: <br /> Mailing Address: <br /> Telephone Number: <br /> † PROPERTY OWNER INFORMATION <br /> Property Owner Name: <br /> Home Address: <br /> Mailing Address: <br /> Telephone Number: <br /> † CONTRACTOR INFORMATION <br /> Name of General Contractor: <br /> Mailing Address: <br /> Telephone Number: <br /> Contact Person on Site: <br /> Site Phone Number: <br /> † UTILITIES <br /> Source of Facility Water Supply: <br /> Backflow Protection: <br /> System to be used for Liquid Waste Disposal (Sewage): <br /> Solid Waste Disposal to be provided: <br /> Grease Interceptor: <br /> † FOOD INFORMATION <br /> List food(s) to be served and/or provide menu: <br /> <br /> <br /> † OPERATIONAL INFORMATION <br /> Anticipated Business Hours: Open: _______________ Close: ________________ <br /> Anticipated Number of Employees: <br /> <br /> <br />Charleys Philly Steaks <br />Menu Provided <br />3223 E. Hammer Lane <br />Stockton, CA 95212 <br />McDonald's <br />Robert Cheung <br />408-207-8154 <br />Walmart Real Estate <br />PO BOX 8050 Bentonville, AR 72712 <br />Stockton City Water <br />Stockton City Sewer <br />Stockton Waste Management <br />2043 Limewood Drive, San Jose, CA 95132 <br />PO Box 1202, Brentwood, CA 94513 <br /> 10AM 9PM <br />20