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SAN JOAQ$ COUNTY AIR POLLUTION CONTROL 0-TRICT <br /> 1601 E. Hazelton Avenue, P. 0. Box 2009, Stockton, California 95201 <br /> Telephone: (209) 466-6781 <br /> Application for AUTHORITY TO CONSTRUCT and PERMIT TO OPERATE q <br /> Date:� � <br /> Application Number: Of 7 9- <br /> An application is required for each operation described in part B of instructions. i <br /> 1. PERMIT TO BE ISSUED TO: Business license name of Corporation, Company, Individual <br /> Owner, Partner, or Governmental Agency. <br /> 6;45- t S �1 v 1` WEST <br /> 2. MAILING ADDRESS: <br /> 4bo � N EaS,- SQL# LA [� E c; f `( <br /> 3. ADDRESS AT WHICH THE EQUIPMENT IS TO BE OPERATED: I CITY ( ) COUNTY ( ) <br /> ,e .-D <br /> 4. GENERAL NATURE OF BUSINESS: <br /> L 7E— <br /> S. EQUIPMENT DESCRIPTION: Pursuant to the provisions of the State Health and Safety <br /> 5 Code and the Rules and Regulations of the San Joaquin County Air Pollution Control <br /> District, application is hereby made for PERMIT TO OPERATE the following equipment: <br /> 5 C) oV <br /> Continue on additional x 11 page if space above is insufficient. <br /> 6. TYPE AND ESTIMATED COST OF BASIC EQUIPMENT: <br /> 7. TYPE AND ESTIMATED COST OF AIR POLLUTION CONTROL EQUIPMENT: <br /> 8. SIGNATURE OF APPLICANT: TITLE OF SIGNER: <br /> ) P ,evrso <br /> 9. TYPE OR PRINT NAME OF SIGNER: 33� - 90 ?a3—;1-4v 93 <br /> NAME: �R O ETELEPHONE NO.: 6 - —o a <br /> alidation D.) use only <br /> Date Application Received: FEB 1 1979 Fee Schedule Number: <br /> SAN JOAQUIN LOCAEiling Fee:$a 0 'Q Permit Fee:$ <br /> EH 01 20 Rev 1/74 - 7/7t; 500 <br />