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Applications Will Be Processed When Submitted Properly Completed. Be Sure ToSignTheApplication. <br /> - APPLICATION t <br /> (For Non-Transterable, Revocable, and Suspendable) <br /> SEPTAGE <br /> ZI ENVIRONMENTAL HEALTH PERMIT _ <br /> LIQUID WASTE <br /> Application is hereby made-to carry on business in the jurisdictional area of t)� in Lo alealth D <br /> JoaquHistrict <br /> rn Business Name (DBA) 1'� Addre <br /> aOwner Address <br /> J Firm Partners, Addresses an lephone Numbers y <br /> aBusiness Telephone No. Emergency Telephone No. <br /> Contractor Licence No. l 1a <br /> L14 <br /> Applicants Name (Print) Title _ Date ^�-- <br /> F:, <br /> Please check Applicable Category(1-7) and Fill in the Required Information <br /> 1:_.❑ PUMPER VEHICLE-PERMIT REGISTRATION (FOR EACH VEHICLE) <br /> For July 1, June 30, 19 Disposal Sites <br /> Description(ake/Yr., Color) <br /> Serial No, CAL, License No. . i :` GAL' Lc: <br />