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ENVIRONMENTAL HEALTH DEPARTMENT <br /> SAN JOAQUIN COUNTY <br /> Donna K.Heran,R.E.H.S. Unit Supervisors <br /> 304 East Weber Avenue, Third Floor Carl Borgman,R.E.H.S. <br /> Director Mike Huggins,R.E.H.S.,R.D.I. <br /> Al Olsen,R.E.H.S. Stockton, California 95202-2708 Douglas W.Wilson,R.E.H.S. <br /> cgC�FORP Program Manager Telephone: (209) 468-3420 Margaret Lagorio,R.E.H.S. <br /> Laurie A.Cotulla,R.E.H.S. <br /> Program Manager Fax: (209) 464-0138 Robert McClellon,R.E.H.S. <br /> Mark Barcellos,R.E.H.S. <br /> APPLICATION FOR DISPOSAL SITE EXEMPTION <br /> & FEEDING OF FOOD PROCESSING <br /> & PACKING WASTE <br /> Name of Property Owner: \�1 C , �� 1'IILI 1 <br /> Address: <br /> Name of Operator: ��&PA 1'�� <br /> Address: \ W"'' Z& S ti <br /> Name of Operator: <br /> Address: <br /> Provide the following information on a scaled drawing not less than one inch equals six hundred feet <br /> (1"=600'). Parcel maps that meet this requirement are available at the San Joaqquin County Assessor's <br /> Office. <br /> • Identify the disposal site location, storage and /or feeding areas and specify the number of areas. <br /> • Identify all dwellings, structures, wells, ponds, lakes, reservoirs, streams, drainage courses, or other <br /> waterways within one thousand (1000') feet of the proposed disposal site. <br /> Provide the following additional information: <br /> • Duration of disposal (dates) <br /> • Turnover time of feeding of waste <br /> • Type of disposal site security (fences/gates/natural boundaries). <br /> • Estimate total quantity in yards or tons per day per acre. <br /> • Provide work plan for applying waste to land. <br /> • Describe contingency plans for selecting alternative sites and provide the location of all possible <br /> alternative sites that could be used in case of inclimate weather. <br /> • Describe vector control procedures for storage of waste. <br /> I agree to provide the above information and receive authorization from San Joaquin County Public <br /> Health Services, Envionmental Health Division prior to placing any waste on this property. <br /> --Z v - <br /> gna r r e w nj r Date ] <br /> ture of 6pe or Date <br /> Application accepted with fee by <br /> Date <br />