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APPLICATION <br /> SAN JOAQUIN COUNTY REFUSE COLLECTOR'S LICENSE <br /> THIS APPLICATION MUST BE ACCOMPANIED BY A CASHIER'S CHECK OR IRREVOCABLE LETTER <br /> OF CREDIT IN THE AMOUNT OF$20,000. (Please print or type.) <br /> 1. Business Name ACES Waste Services Inc. Phone 209-296-2237 <br /> 2. Business Address 19801 Berry Street,Pine Grove, CA 95665 <br /> (Address) (City) (Zip Code) <br /> 3. Owner(s)Name Please see attached list of owners Phone see attached <br /> Home Address see attached <br /> (Address) (City) (Zip Code) <br /> 4. County Business License Number City of lone—890108 <br /> 1 hereby certify under penalty of perjury that the above information is true and correct to the best of my knowledge <br /> and belief. <br /> Dated March 27 2009 <br /> SIGNATURE OF LICENSEE OR <br /> AGENT <br /> FOR COUNTY USE ONLY <br /> DEPARTMENT OF PUBLIC WORKS <br /> 1. Received by Date <br /> 2. Deposit/Letter of Credit received. [✓, Yes [ ] No <br /> 3. Applicant holds current County Business License. [JJ Yes [ ] No <br /> 4. Applicant has submitted proof of adequate Workers' Compensation and / <br /> Casualty Insurance. [ ] Yes [ ] No <br /> 5. Applicant has submitted required financial statement. Yes [ ] No <br /> 6. R vi an recommended for approval by: <br /> FOR COUNTY USE ONLY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 1. Received by �pg��- �, C�\ ,� Date <br /> 2. Applicant has the ability to comply with all applicable County regulations and ordinances and State Law. <br /> M Yes [ ] No <br /> 3. Reviewed and recommended for approval by: <br /> 1 <br />