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_. .G <br /> APPLICATION - SITE APPROVAL <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 9�/FORT'`p FILE.NUMBER: SA- <br /> Other <br /> Describe any items of historical or archaeological interest on-site(e.g. emeteries or structures): <br /> NONE <br /> Describe any on-site or off-site sources of noise or vibration(e.g.freeway noise,heavy equipment,etc.): <br /> 721 Case Loader KO -Qr mbo 5000 Shredder <br /> 2000-gal Water Truck KRO <br /> Describe any on-site or off-site sources of light of glare(e.g.parking lot lighting,or reflective materials used): <br /> Terex/Amida/AL40 <br /> Describe any on-site or off-site source of odor(e.g.a dcultural wastes): <br /> _-GLejaa-clinni nn <br /> Describe any displacement of people that will be caused by the project e. . numbers of people,housing units): <br /> NONE <br /> AUTHORIZATION SIGNATURES <br /> ONLY THE OWNER OF THE PROPERTY OR AN AUTHORIZED AGENT MAY FILE AN APPLICATION. <br /> I, the Owner/Agent agree, to defend, indemnify, and hold harmless the County and its agents, officers and <br /> employees from any claim, action or proceeding against the County arising from the Owner/Agent's project. <br /> 1, further, certify under penalty of perjury that i am (check one): <br /> ❑ Legal property owner(owner includes partner, trustee, trustor, or corporate officer) of the property(s) <br /> involved in this application, or <br /> �i Legal agent(attach proof of the owner's consent to the application of the property's involved in this <br /> application and have been authorized to file on their behalf., and that the foregoing application statements <br /> are true and correct. <br /> Print Name: Humberto Valdez Signature: Date: <br /> Print Name: Lvnda Delauidice Signature: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> Print Name: Signature: Date: <br /> FADEVSVmPlanning Application FormslSite Approval.(Revised 02-03-10) Page 5 of 9 <br />