Laserfiche WebLink
2817 CHERH RADIATOR <br /> STOCKTOMY CA Ams 13 <br /> g ONG5475 <br /> 9= <br /> ' ad'✓�I0R`O,'�� -; , >a <br /> PUBLIC HEALTH SERVICES OF SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION <br /> BUSINESS OCT CENSE SUiVH•7C <br /> 1. Does the business handleHazardous Material? Yes No [ ] <br /> a. Type: �rANk SS-14-z-,19" 9 (LAAlrlP-eee- <br /> z ✓� _ <br /> b. Amount:,.ai) , iA//o Ns' <br /> 2. Does the business generat/e� Hazardous Waste? Yes I No [ ] <br /> a. Type: i6cr_ <br /> b. Amount generated per month: 9d aZllfj,�' <br /> C. EPA#: GgL X2/9,0 �S.S <br /> d. Storage method and time stored on premise-Zln/ Tib 1✓k <br /> e. Waste disposal method:54 Pf- IAIALZ c Ne /l') ICAC l r i�y�Sa9�Z9�z <br /> AAS r/, k ee z�T' v��� o�.m 2' 'V'r s v/c am <br /> 3. Is the business presently under any Permits? Yes [ ] No <br /> a. State Permit P: <br /> b. CRWQCB Discharge Requirement #: <br /> C. County Permit #:/r <br /> R 2 P t, ) r );�- 9_5 -3 <br /> d. Other: <br /> 4. Type of sewage disposal system: <br /> l <br /> a. Private Septic System /)� r ZA L� I C S�J <br /> PHS-EHD Sanitation Permit #: YOXI T l <br /> b. Public Sewer <br /> Name of System: <br /> City Discharge Permit #: <br /> 5. Type of Water Supply: <br /> a. Name of Public H2O System: <br /> b. Private Well: ,(J I t/A2- (L we-,' I <br /> e ,' / <br /> PHS-EHD Well Permit #: /� <br /> Number of Employees: <br /> Distance from septic system(s) : S <br /> Distance from Underground Storage Tank: <br /> Distance from Hazardous Material Storage: <br /> Distance from Hazardous Waste Storage: <br /> EH 22 035 (Rev: 4/92) <br />