Laserfiche WebLink
Public Health Services of San Joaquin County <br /> Environmental Health Division <br /> BUSINESS LICENSE SURVEY <br /> 1. Does the business handle Hazardous Material? Yes n p No [] <br /> a. Type: Pa"I. L-sapee5 ,-'rk NNa.^S SOI✓Ga y S.au'�t fQCrJrCfS <br /> b. Amount: C✓r^reL4-9xy5e-s ZOe4[[004 ,f "40N COIIP.Gd-tVGIV <br /> 2. Does the business generaHazardous zardous Waste? Yes [y No [] <br /> a. Type: ycLs //e sols-45, Oki NNLr�sr Ict4ULM5 I!C,(;•I L <br /> b. Amount generated per month: /O_gall D"5/IDgWA CO llee-t;4,be& <br /> C. EPA#•-6� 5Z4 �-,x4i✓IOS Al131 'g5 / - / <br /> d. Storage method and time stored on premise: Athr, edO05 CVC45 w"If 4e SM✓LOI t. <br /> e. Waste disposal method: C� edeti ct exAa%A e-149 ha <br /> 3. Is the business presently under any Permits? Yes [] No <br /> a. State Permit #: <br /> b. CRWQCE Discharge Requirement #: <br /> C. County Permit#: <br /> d. Other: <br /> 4. Type of sewage disposal system <br /> a. Private Septic System ZZ R.B� <br /> PHS/EHD Sanitation Permit #: 8BJ 31 <br /> b. Public Sewer <br /> Name of System: <br /> City Discharge Permit#: <br /> 5. Type of Water Supply n /, <br /> a. Name of Pulic HO System: <br /> b. Private Well <br /> PHS/EHD Well Permit#: <br /> Number of Employees: I <br /> Distance from septic system(s): ,,/V' <br /> Distance from septic system(s): LIM— <br /> Distance from Underground Storage Tank: <br /> Distance from Hazardous Material Storage: 41(A <br /> Distance from Hazardous Waste Storage: Nl� <br /> EH M 035 (11ev 4/90) <br />