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<br /> L1 rlew 1:11 Prorr I,n at r-Js�ia�i-:0if) -1"a Ci I iO,
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<br /> VAA"-,-4"� —ticvk, �31-7
<br /> (PICL15e Check the appropplati--dcs criptioa. --jAof mll --nd 0„ "i''I
<br /> FOOD PROGRAM(1600)
<br /> ❑ Restaurant: Seating apacitj -Iqu--re Foo(jgc Food 11--indlers Course required: VES ❑ ?to 11
<br /> ;slot �%ith Foo-1 Preparation ❑ELJV.�adia- MacLiocs•-11urnber of Units
<br /> El Comrais3iq El Df-, only ❑L V-
<br /> El Retail Mai4,et—Square foctace ❑ -e,,idi Meat Market only El t,juitipic,Dcparini�nils El Prcpackagpcd GooJ3 Only
<br /> D Mobile Food Vollicle 4/chicle TjT),- Color
<br /> Kcgislmaion U Liccnsc N — Sti '1'
<br /> El Mobile Food Prep Unit-M3J:c vchicic T)P,! color
<br /> Registr--tivin rSticker"
<br /> El Tempo".o-Food --Date,of operation from to D Ice I'laut
<br /> El Special -Dales of op-r-ition from to n- Pra duc,-S(a a d
<br /> DAIRY PROGRA-rl (2000)
<br /> El Grad, A Daily El Gr-idc B ED--i v), 0 T.ILt:-p j,p.0 sc r--ijurnber of Containers in 1,M6-Bead Unit
<br /> C u p,,,, El State Facility Suvchargc(2399)
<br /> IL4,Z.krW0US WAS71f E PPOGFUNI(2200)
<br /> El Harardous Waste GenettedPer Ye3s 0 Bucycle I SySteal(2299)
<br /> El CRT Offsite I-Imidlecs 2211.) F-1 S I I vc r Only(2222) Ej 1�-ppllaiicc RecyokrS(.2Z]7)
<br /> Tier,-,d Vcvuoit iiri`F.--.Cil;' -El C-c-adtalouaily AuihnrizCd(CA) 03 Cc)1d't'(-,Lvz3lly EXCTIV((-E)
<br /> 0 Pea uit-Dy-Putc;Fixed Unil -Lit-f3y-Rtjl,--iloufchold -ffastc
<br /> El IkE 0V-E G-RO U VID ST OPA C E TANK FA C L IT'-J(AST)(2390) Tlunibcr o[AST
<br /> UNDERGROUND ST01ucs (-UST)-t--ROGRAM(2300)U-: FIST amif ror-s
<br /> HOUSMG PROGRAM(24o0)
<br /> El 11o(cU-Mo(d—Numb-c of Uni!s El J.zjjcr
<br /> _e Lipt
<br /> Emptoye-,110-lsirg(2700) AlrousisiT.abor C-qjTIj7,4PP[iCQ601t
<br /> SITE IlIMGATJON(2900) UNDERGROUND 1143EC-CION CONTROL(3000)
<br /> El Eazivouuicufll Mscssnv!a, F-] iJST-CA1'Si(e El L,-,c:!l paup Site CJ 1'4I'L1SEPC1<!aadp Site El u1c.csi(e
<br /> El Abandoned MVSitp- 0 Lior-?-NPL!SEP Cleanup Site El R-IVOCU ClQaaup Sib! "Q"
<br /> EW-CREATIONAL HEALTH PROGRAM(3000)
<br /> jiumi)er of rooi-4spas at!-.z,-iliLy El r a.-,I FJ Spa. FJ Out 7-iouspa Ell Ptztura Dat-aip.-
<br /> VECTOR.r-OtITROL PROGRDI.1,1(4000)
<br /> El PIJUM-v FarEll—Maxiniur-ti numbcr of birds a a C I
<br /> TAT-100,JIODY PIERCING,PURMAIAENT COSMO TIG PROGRX-A(-i 100)
<br /> C1 T2[tc,DLng(4 12 1) 0 B c dy Piercing(.1120) 1:1
<br /> LIQUID VfASTE PROGRAV1(4200)
<br /> Uccase:1
<br /> ❑ rump-ry:,rd ❑ P.i-k-i g c T r c a r,-L a a tj ❑ CLur-ic--I Toilcts—lluniher�,f UnAs
<br /> SOLID V/A S I E- F R D G,17-3,N1(4 4 0 0)
<br /> G Landfill ID T r�risfcr S-fation El Ac f canner-y Was(c si(c Si(z
<br /> AA F
<br /> 11 r-efu-�, >-io -u yd --Number of UniL-1- C]
<br /> NEDICAL!IASTE-FR.OGR,1'-'J(,1506)
<br /> El Tr,nRrl:-t-7Zii.:i,.
<br /> 67 U D LiC .'(!kfF=r, 'i' i F-, i Cii J) f 0
<br /> 1-a jF-j- yTK,.,Cur,-T1115
<br /> Ua-,,T I,
<br /> k7 11
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