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RECEIVED <br /> JUL 12 2016 <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERWCES <br /> APPLICATION FOR DISPOSAL SITE EXEMPTION <br /> & FEEDING OF FOOD PROCESSING <br /> & PACKING WASTE <br /> Name of Property Owner: "'A <br /> Address: Z 6 Do)� Csclo a 753L,) <br /> Name of Operator: C,\/I- A <br /> Address: �� O�� DL-0 <br /> C� � SL O (� �� � S 3 Zc� <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 Joagquin County Assessor's Office. <br /> • Identify the disposal site location, storage and /or feeding areas and specify the number of areas. Jnr <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 /> L /1-- -7- 6 -11 <br /> Signature of Property Owner Date <br /> Signature of Operator Date <br /> Application accepted with fee by <br /> Date <br /> e '1 <br />