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01/27/2004 14:16 E.E.C. � 120946e3433 NO.029 P05 <br /> CITY OF STOCKTON <br /> MUNICIPAL UTILITIES DEPARTMENT <br /> REGIDNAL WASTEWATER CONTROL FACILITY Septic Tank Truck <br /> STOCKTON,CAt.FFQRNIA Ejd2Qe <br /> 2600 NAVY DRIVE Special Application/Permit <br /> (20)937-0760 <br /> FAX: (RO9)937.8708 For Wastewater Discharge <br /> PART S -- BUSINESS DESCRIPTION <br /> Applicant Business Name: fl i- ; -t .3 4i r-) <br /> Address of premise discharging wastewater: <br /> Street 21!1 Al, <br /> City u n <br /> Zi 5 Z0 Z <br /> Business Address- <br /> street 919 N J-c, 5 4 r e. f' <br /> city ;�c n Zip 4 5 ZU z- <br /> Mailing 19 c• S e <br /> City `,��-,c L4,'Q state-LA-zip °S S Z <br /> Chief Executive Officer., <br /> Name Pg_±er J3ernr-xd,cg6) TitleGrrtar"I 014na4er <br /> Mailing Address,"'i City-S-1 c state _._.ZiP `3 ? y Z <br /> Person to be contacted about this application: ' <br /> Name u c r ;tr Titl �iJ4���'� Phonet,L`():1GC,2-2.3C3C <br /> Person to be contacted In case of emergency: <br /> Name af e' Q� + � � �C � 1"ftleS�t:tat�„�rr <br /> Day Phone � � "1't i -23 C. Night Phone <br /> Business Activity fFcIr; jv SIC <br /> Type of Products: <br /> VI1* <br /> Descrlptlon of wastswater generating operations. <br /> c L <br /> f vw r i ,e61, a r r n <br /> i z r o c7 .► cr <br /> � +. r• r t ,�..n 1 L• 1` f' C s �rd f f"C C O111 <br /> I• t'd C U r L T rc T <br /> e .) -�' *4 rr c, . _ r.�t r 1 <br /> r tV. <br /> 1 o e� l Gh `91� LIa IT I' U C� r��"J <br />