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SAN JOAQUIN LOCAL IMAL'1'I1 DIS'TItter <br /> ENVIRONMMAL IIL'AL'TII DiviswN <br /> Business License Survey <br /> 1. Does the bUslhcss handle Razard-osu.,; Material? <br /> a. Type T�d-J6 we!° v --- <br /> b. Amount <br /> 2 . Does the business generate Ilazarduus WasLc7 (�G¢J <br /> n t 'Type O <br /> b. Amount- generated per month <br /> C. PPA I I ` <br /> d. Storage method and time stored on pr.emine <br /> e. Waste disposal method. <br /> 3 . Is the business pr.estenLly under. any PermiLs7 <br /> a. State Permit I <br /> b. CRWQCD Discharge Requirement- I <br /> C. City Permit I <br /> d. County Permit I <br /> C. Other <br /> 4 . Type of sewage disposal sysLem <br /> n . Private Septic ✓✓ <br /> Under SaniLa Llon PermIL I <br /> b. Public Sewer <br /> Name of System <br /> City Discharge Permit I <br /> 5 . Type of Water Supply <br /> n . Public <br /> Name of System <br /> b. Private Well Permit I ✓ a 50 <br /> Number of Employees <br /> Distance from septic system( s ) <br /> Distance rr.om Underground Storage 'Tank <br /> DinL•ance from Ilazar.dous Material SLorage <br /> Distance form Ilazardous Waste Storage <br /> RII 00 10 ( 4/06 ) <br />