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COMPLIANCE INFO_2025
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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H
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HARDING
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535
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1600 - Food Program
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PR0521587
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COMPLIANCE INFO_2025
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Entry Properties
Last modified
10/8/2025 12:19:27 PM
Creation date
10/8/2025 12:18:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1600 - Food Program
File Section
COMPLIANCE INFO
FileName_PostFix
2025
RECORD_ID
PR0521587
PE
1623 - RESTAURANT/BAR 1-20 SEATS
FACILITY_ID
FA0014664
FACILITY_NAME
GUAMUCHILITO SUSHI
STREET_NUMBER
535
Direction
W
STREET_NAME
HARDING
STREET_TYPE
WAY
City
STOCKTON
Zip
95204
APN
13705009
CURRENT_STATUS
Active, billable
QC Status
Approved
Scanner
SJGOV\ymoreno
Supplemental fields
Site Address
535 A W HARDING WAY STOCKTON 95204
Suite #
A
Tags
EHD - Public
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Existing Facility□ New Facility <br />San Joaquin County Environmental Health Department <br />Application Form <br />Facility Name <br />Site Address <br />APN <br />□ Consultation ^Change of Owner □ Repairs or Remodel □ Other <br />License Plate Number VIN <br />□ Billing Party □ Facility Owner □ Facility Contact □ Property Owner □ Contractor □ Architect <br />Billing Party Facility Owner ^Facility Contact □ Property Owner □ Contractor □ Architect <br />If contractor, indicate type and license number <br />□ Billing Party □ Facility Owner □ Facility Contact □ Contractor □ Architect <br />First Name If contractor, indicate type and license numberLast name <br />Address City State ZIP <br />Phone Phone Email <br />□ Billing Party □ Facility Owner □ Facility Contact □ Property Owner □ Contractor □ Architect <br />First Name If contractor, indicate type and license numberLast name <br />Address City State ZIP <br />Phone Phone Email <br />A1 DATE:T <br />□ OTHER AUTHORIZED AGENT □ PROPERTY / BUSINESS OWNER □ OPERATOR/MANAGER <br />Title <br />PE <br />□ Check U□ Cash <br />Rev 07/10/2024 <br />□ Application for <br />Operating Permit <br />Contact Types <br />required <br />If mobile food truck or <br />pumper truck <br />Payment <br />Received By <br />ZIP <br />ZIPStateCity <br />Type of Service <br />Requested <br />Comments <br />Linked FA ID <br />FAW >4 <br />__Record NumberSR2-5(?>|SSe> <br />20^005^[jfconfirmation It <br />.SosAi <br />Supervisor District <br />State <br />CH <br />First Name <br />Address ~ <br />Rhone| Phone <br />UH 20K ;by authorize the A J <br />Assigned To .Accepted By <br />Date .BlfcU'S <br />City <br />Email , . <br />□ Property Owner <br />BILLING ACKNOWLEDGEMENT: I, the undersigned property or business owner, operator or authorized agent of same, acknowledge that all site and/or project <br />specific ENVIRONMENTAL HEALTH DEPARTMENT hourly charges associated with this project or activity will be billed to me or my business as identified on this <br />form. <br />I also certify that I have prepared this application and that the work to be performed will be done in accordance with all SAN JOAQUIN COUNTY Ordinance Codes, <br />Standards, STATE and FEDERAL lawa I j Q . q « < 0/1 <br />APPLICANT'S SIGNATURE: DATE: bO ~ U C 3 <br />If APPLICANT is not the BILLING PARTY, proof of authorization to sign is required 41/6 fl (,■ <br />AUTHORIZATION TO RELEASE INFORMATION: When applicable, I, the owner or operator of the property located at the above site address^iaceby authorize tl <br />release of any and all results, geotechnical data and/or environmental/site assessment information to the SAN JOAQUIN COUNTY ENVIRONMtj COI4, <br />DEPARTMENT as soon as it is available and at the same time it is provided to me or my representative. <br />F66 A. <br />Last name . <br />1^,0
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