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San Joaquin County <br /> Environmental Health Department DIRECTOR <br /> Donna Heran,REHS <br /> s:' 2 1868 East Hazelton Avenue <br /> Stockton, California 95205-6232 PROGRAM COORDINATORS <br /> Robert McClellon,REHS <br /> Jeff Carruesco, REHS, RDI <br /> ' P Kasey Foley,REHS <br /> 4.% g <br /> Website: www.sjgov.or /ehd F o•R�� Linda Turkatte,REHS <br /> Phone: (209)468-3420 <br /> Fax: (209)464-0138 <br /> APPLICATION FOR DISPOSAL SITE EXEMPTION <br /> & FEEDING OF FOOD PROCESSING <br /> & PACKING WASTE <br /> Name of Property Owner: vk /itt1--f� �v� S <br /> Address: 4,C>, yrs^--Z3 <br /> Name of Operator: o v,a� <br /> Address: <br /> Name of Operator: <br /> Address: <br /> Provide the following information on a scaled drawing not less than one inch equals six hundred feet(1"=600'). <br /> Parcel maps that meet this requirement are available at the San Joaqquin County Assessor's 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 alternative <br /> 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 Health <br /> Services, Environmental Health Division prior to placing any waste on this property. <br /> "d --' — - 3 <br /> Signature of Property Owner Date <br /> Signature of Operator Date <br /> Application accepted with fee by <br /> Date <br />