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•11-02-1994 09:28RM FROM TO 17147790068 P.04 <br /> tp0.D.y) ravi.wd E/Z6M <br /> New CnaFge Edit <br /> GENERAL PROGRAM TILE : ' <br /> FACILITY MAW Nestle Facility, 4343 Fremont, Stockto CA <br /> FACILITY 10 N <br /> PRIOR WEEPS/COMP s <br /> RECORD10 tf - <br /> ' - Grade 9 Xilk Dispense*' __ Xuber of Conteineca in NulCi•Head Lhli <br /> _ DAIRY: Crede A <br /> Herktt CM+niesary <br /> Nubile Food _ Product Stand.^_ -Ica plant _•.,, . <br /> ' FOOOc 'Rt4t BUfanC --Sa Ft Market V/food Prep•. T / N <br /> Seating Capacity Ve+diro Koch irw *,t r of VemIns unite <br /> Taaporary Food FoCllitY ....... Special Food Event IF s . OOtor <br /> Food Veh lale � Maka .�------� <br /> NAZgR0004 VASTE: - Tons Generated/Tr <br /> TIERED PERMIT FacilitY : CA, CE __ PSR <br /> Jail/£Mogi Inatitutian Housing Abataaa t <br /> HOUSTHG: NOtel/Notal No. of Unita.__ ApproN Oates of Ot <br /> ' to <br /> No. Of EaPloyeu � clDat>cY _J—�� <br /> Entiloyee No 411 <br /> LIOU10 VASTE: pumper Vehicle _ PuMer Yard __ CheeilCel nal Seca eon <br /> package TA Plenc <br /> ' - Carl OkiLf Cenerstar tan Canereter �e <br /> Acuta llcd Nvralne <br /> MEDICAL VAST61 Priam'Y Wra _^ Storage l a!0 7 ,� TrYefer 1[s LW Hauler — <br /> Vat CI IniC <br /> storage (2-101 —. Storage- ((,-l0) <br /> ' RECREATIONAL WEALTH: PDdI/Spa .F_ Nunber of Pool, Out of Service Pool Natural RathitXl Place <br /> loc <br /> $ SITE'MITI WTIONt Ern`Firon Assess % UST/CAP NeL Waste � NAL Nat PPL <br /> DISC NPL Site R9/X20 0 -- <br /> ' other Lead Agency Site �_ Agency: RLiOCB Other <br /> Waste Storage Fee —_ Ag <br /> Vaste/Ey"pt Site <br /> SOLID WASTE: Landfill transfer Sta Recycling Fac , Stationery CRepeoter lite <br /> SW vehicle W9. Dualattr Wo. � <br /> Kennel <br /> VECTOR CORTROLe poultry Fern Naa W"b'r of Rude <br /> DAT NIGHT <br /> E[IERGENCY NOTIFICATION for this FACILITY ardor PRo" <br /> (714 ) 77% 0052 (_) <br /> CONTACT I : Gre orT K. Mitchell 1213 j 717- 920 <br /> CONTACT 2 : Michael' Falmer <br /> ' � PROGRAM ELENtAi s QAtAEMT STATUS . <br /> OESIPnATEO EXRLOYEE 7 <br /> IXSPORIdI CME - <br /> ' Al Or UNITS.; EPA ID <br /> gILLI NO ani P]ITPl iANCE ACKROIR.EOfp1EYT: I, rM n+tiera Sanaa avr�en', aparator or soot of 800, acbwaled" that ell site and/et <br /> ch easocietcdvith this facility or activity will be billed to the party identified as the <br /> ' project specific PHS/EHD hourly ar9es performed rill be done <br /> EIILING PARTY on-this.farm. I also certify ttset I have prepared this epplitst inn eta that the work to Fe Lral <br /> in xcerd&me with all applfcab a SAN JMWIN COUITT 0MInanca Coda md/nr St <br /> ard0r0a end Stets and/or Federal laws. <br /> ' ApPLICAMTIS SIGNATURE : >_tc e <br /> Gr o November 2, 1994 <br /> Branch Manages oete:_ <br /> Title; livable, 1 the oaten, operator or agent of Casae, or <br /> ' AUTHORIZATION TO RELEASE tNFORMATIOPI: In addition to smt alta,"Itathekghraleoaa 04 any and all r its, ane¢tehnfoel date and/or <br /> ove <br /> the prgperzy located at iho abbite eddr s hcreb/ u <br /> trwirormental/Site OSSMsnt:nt Informeticn to SAN JOAOUIN =My RALIC iNALTN SERVICES ENVIRCiW TAL RMTH DIVISION as scan as <br /> It 'ie available and at.the same time It is provided to ee.or any r*pr~Tetivm- <br /> ' - }. bate of Payment Payment Type Receipt i Check R Aeevd By <br /> Almut Paid Fee'AnM1%mt - <br /> Ad7 /���� IAIT CLK <br /> YENS <br /> ' 11-02-94 08 : 22AM P004 942 <br /> R=95% <br />