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QUIfy <br /> PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DIVISION i X <br /> Ernest M. Fujimoto, M. D., M.P.H., Acting Health Officer <br /> 304 E. Weber Ave., Third Floor • P. O. Box 388 a Stockton, CA 95201-0388 <br /> 209/468-3420 <br /> PLICATION FOR DISPOSAL SITE EXEMPTION <br /> FEEDING OF FOOD PROCESSING <br /> PACKING WASTE <br /> Name of Property Owner: a a[ � Q A_S ( C 1Q <br /> Address: <br /> Name of Operator: E A Q 6 • <br /> Address: <br /> Name of Hauler: ,s j C O i C k PP-( Z-9- <br /> Address: n 6 d E S ( 0 <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 Joaquin County Assessor's Office: <br /> • Identify the disposal site location, storage and/or feeding areas and specify the number of area. <br /> • IdenSt all dwellings, structures, wells, ponds, lakes, reservoirs, streams, drainage courses, or other <br /> wateMays with one thousand feet (1,000') of the proposed disposal site. <br /> Provide the following additional information: <br /> • Duration of disposal (dates). <br /> • Turnover time of feeding of waste. g. <br /> • Type of disposal site security (fences/gates/natural boundaries). . 9"X <br /> • Estimate total quantity in yards or tons per day and per acre. m'y-,) ^, (c <br /> • Provide a work plan for applying waste to the land. <br /> • Describe all contingency plans for selecting alternative sites and provide the location of all alternative sites <br /> should weather conditions warrant this condition. <br /> • Vector control procedures for storage of waste. <br /> I agree to provide the above information and receive authorization from the San Joaquin County Public Health <br /> Department, Environmental Health Division prior to the dumping of any waste on this property. <br /> c� <br /> Signature of Propertt0 ner Da <br /> Signature of Operator /� e <br /> Application accepted with fee by <br /> �r Date <br /> ` 3 S A Division of San Joaquin County Health Care Services <br /> 3 <br />