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'SAN JOAQUIN LOCAL IHEAL DISTRICT <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Business Licence Si rvey <br /> 1. Does the business handle Hazardous Material ? <br /> a. Type <br /> b. Amount <br /> 2. Does the bub ill <br /> ss generate Hazardous Waste? <br /> a. Type <br /> b. Amount gen rated per month. <br /> c. EPA # <br /> d. Storage met od and time stored on premise. <br /> e. Wasteldispo al method. <br /> 3. Is the buiness presently under any Permits? <br /> a. Stateiermit <br /> Permi # <br /> b. CRWQC Disc arge Requirement # <br /> c. Citv # <br /> d. Count Permit # <br /> e. Other <br /> 4. Type of sewage disposal system. <br /> a. Private Septic %�— <br /> Under Sanitation Permit # <br /> b. Public', Sewer'I <br /> Name of Syst m <br /> City Dischar a Permit # <br /> 5. Type of Walter Su ply <br /> a. Public <br /> Name of Syst m <br /> b. Private well Permit # L� <br /> Number of Em loyees j4- <br /> Distance fro septic system(s) <br /> Distance fro Undergroung Storage Tank <br /> Distance fro Hazardous Material Storage <br /> Distance fro Hazardous Waste Storage <br /> i <br /> it <br /> 4-18-86 <br /> P.L V <br />