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SAN JUAilU1N LUCAL Htf i U1SIRICT XLAO �S�.r <br /> �oJ <br /> ENVIRONMENTAL HEALTHID VISION 7�O s Gf D/xo�. cS7' <br /> Business Licence Survey PIC .0-t --02-TJ <br /> S� , .r�/�/ 9 <br /> 1. Does the business handle Hazardous Material ? <br /> a. Type Parma) 7-L� ^r <br /> b. Amount " I-3b��°I-ZO t <br /> 2. Does the business generate Hazardous Waste? tip <br /> a. Type <br /> b. Amount generated per month. <br /> c. EPA # <br /> d. Storage method and time stored on premise. <br /> e. Waste disposal method. <br /> 3. Is the business presently under any Permits? AJIA <br /> a. State Permit # <br /> b. CRWQCB Discharge Requirement # <br /> c. Ci tv Permit # <br /> d. County Permit # <br /> e. Other <br /> 4. Type of sewage disposal system. <br /> a. Private Septic <br /> Under Sanitation Permit # <br /> b. Public Sewer ✓ <br /> Name of System 'SToc-kroO-) <br /> City Discharge Permit # <br /> 5. Type of Water Supply <br /> a. Public ✓ <br /> Name of System STS-'u w*-� <br /> b. Private Well Permit # <br /> Number of Employees 7 <br /> Distance from septic system(s) <br /> Distance from Undergroung Storage Tank <br /> Distance from Hazardous Material Storage ,-,//4 <br /> Distance from Hazardous Waste Storage ti14 <br /> 4-18-86 <br /> RLV <br />