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w a w, <br /> . <br /> S <br /> ,ONMENTAL HEALTH DIVI dN <br /> t ,isinei Licence Survey <br /> 1.. Does .the business handle Hazardous Material?, .� <br /> arType <br /> O <br /> r.r 1•: <br /> b. ? Amount 5_� .� Mix <br /> , <br /> 2 Does. the- business`.generate Hazardous Waste?o �S <br /> a.'0. >Type i,,t nj� ovt <br /> `= b. Amount generated per month. l0D <br /> c. EPA I *_At, a <br /> d. Storage method and time stored on premise. <br /> i <br /> e. Waste disposal method.Ape - eh <br /> 3. Is the business presently undel any Permits? <br /> a. State Permit I <br /> b. CRWQCB Discharge Requirement I <br /> c. City Permit I <br /> d. County Permit I <br /> e. Other <br /> 4. • Type of sewage disposal system. <br /> a. Private Septic �' <br /> Under Sanitatiod Permit N <br /> b. Public Sewer 'j1A <br /> --- - Name—of System ' <br /> City Discharge Permit, I + <br /> S. . Type of Water Supply <br /> -a. - Public - <br /> Name of S t�e 16�"' <br /> b. Private Well Permit I <br /> Number of Employees <br /> Distance from septic system(s) <br /> Distance from Undergroung Storage Tank "— <br /> Distance from Hazardous Material Storage a,4 c" <br /> Distance from Hazardous Waste Storage a� <br /> s <br /> ,.4-18-86,.' <br /> RI V <br />