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PUBLIC HEALTH SERVICES <br /> SAN JOAQUIN COUNTY z� <br /> ENVIRONMENTAL HEALTH DMSION " <br /> Karen Furst, M.D., M.P.H., Health Officer •. P <br /> 304 East Weber Avenue, Third Floor • Stockton, CA 95202 <br /> 209/468-3420 <br /> APPLICATION FOR DISPOSAL SITE EXEMPTION <br /> & FEEDING OF FOOD PROCESSING <br /> & PACK G WASTE <br /> Name of Property Owner: iC_ e'k-%'—( E-L <br /> Address: <br /> t <br /> Name of Operator: <br /> Address: _ <br /> Name of Operator: ' <br /> Address: _ gyp <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 Joaquin 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 cointingency pians 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, En ' mental Health Division prior to placing any waste on this property. <br /> I � A hr, A --4- <br /> Signature of Prope wner Date <br /> Qt�a - % 1A i� �— j — <br /> Signature of Operator Date <br /> Application accepted with fee by <br /> Date <br /> A Division of San Joaquin County Health Care Services <br />