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A plications Will Be Processed When Submitted Properly Completed. Be Sure To Sign The Application. <br /> APPLICATION <br /> (For Non-Transferable, Revocable,'and Suspendable) SEPTAGE <br /> ENVIRONMENTALIIEALTH.-PERMIT <br /> LIQUID WASTE <br /> Application is hereby made to carry on business in the jurisdictional area of-the San Joaquin Local Health District . <br /> yBusiness Name (DBA) Address _ <br /> 4 Owner y :. .Address <br /> j Firm Partners, Addresses and Telephone Numbers " <br /> CL Business Telephone No. Emergency Telephone No. <br /> Contractor Licence No. <br /> L Applicants Name (Print) Title - Date <br /> Please check Applicable Category (1-7) and Fill in 4he Required Information , <br /> 1. ❑ PUMPER VEHICLE PERMIT REGISTRATION (FOR EACH VEHICLE) <br /> For July 1, June 30;19 <br />