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�oP co Adh y= I USE PERMIT APPLICA { SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT FILE NUMBER: UP- �1FOR� Other Describe any items of historical or archaeological interest on-site(e.g.cemeteries or structures): None known. Describe any on-site or off-site sources of noise or vibration (e.g.freeway noise,heavy equipment,etc. : Heavy equipment will continue to be used for construction,daily operations, and closure of landfill. Describe any on-site or off-site sources of light of glare(e.g. parkinglot lighting, or reflective materials used): Portable light stands are utilized to complete refuse disposal and cover activities during winter months. No additional lighting is ropose . Describe any on-site or off-site source of odor(e.g. agricultural wastes): Typical odors associated with landfills i.e. landfill gas, refuse). Describe any displacement of people that will be caused by the project(e.g. numbers of people, housing units): None. AUTHORIZATION SIGNATURES ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and employees from any claim, action or proceeding against the County arising from the Owner/Agent's project. I, further, certify under penalty of perjury that I am (check one): X Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) involved in this application, or ❑ Legal agent (attach proof of the owner's consent to the application of the property's involved in this application and have been authorized to file on their behalf., and that the foregoing application statements are true and correct. Print Name: Mike Caprio Signature: Date: �. Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: Print Name: Signature: Date: F:\DEVSMPlanning Application Forms\Use Permit.(Revised 02-03-10) Page 7 of 9