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! Applicatlo I Be Processed When Property Completed.Be Sure To The Application. <br /> APPLICATION FOR INSPECTIO <br /> NO CARBON NECESSARY AND NON TRANSFERABLE, REVOCABLE,AND SUSPENDABLE SOLID WASTE <br /> ENVIRONMENTAL HEALTH PERMIT <br /> SOLID WASTE <br /> Application is hereby made to carry on business under Permit in the jurisdiction area of San Joaquin Local Health District. <br /> U Business Name(DBA) Sunrise Sanitation Address 403 S. Lincoln, Stockton <br /> C Owner Sunrise Sanitation Service Address Orawpr K, Stockton <br /> j Firm Partners,Addresses and Telephone Numbers <br /> ILL Business Telephone No. Emergency Telephone No. <br /> Franchise Area Served <br /> L Applicants Name(Print) Title Date <br /> Please check Applicable Category(s).Fill in the Required Information,Return all 3 copies. <br /> S <br /> ❑ SOLID WASTE DISPOSAL SITE,NO.39-AA- �P`' <br /> ❑ NEW SITE PERMIT aP� <br /> ❑ SOLID WASTE TRANSFER STATION - <br /> ❑ INDUSTRIAL WASTE GENERATOR . <br /> ❑ STATIONARY COMPACTOR(20 yd.or greater) ISNOW- <br /> JV O <br /> ❑ HAZARDOUS WASTE GENERATOR <br /> ❑ INFECTIOUS WASTE GENERATOR <br /> ❑ WASTE STORAGE FACILITY <br /> ❑ NEW SITE APPLICATION FEE <br /> ❑ MIXED WASTE RECYCLING FACILITY <br /> ❑ MANURE STORAGE SITE <br /> ❑ SITE EXEMPTION APPLICATION <br /> �tjO <br /> VEHICLES AND CONTAINERS(Fill Supplemental Form) <br /> ❑ COMPACTOR TRUCK No.to be permitted <br /> COLLECTION TRUCK No.to be permitted 6 <br /> ROLL-OFF TRACTOR No.to be permitted <br /> ❑ ROLL-OFF TRAILER No.to be permitted <br /> (No. to be used dually as Limited Waste Hauler Vehicle) - - - - - - - - - - - - - <br /> 0 RENDERING,VEHICLE No.to be permitted <br /> ❑ MANUER VEHICLE No.to be permitted <br /> ❑ FERTILIZER VEHICLE No.to be permitted <br /> ❑ LIMITED WASTE HAULER VEHICLE No.to be permitted <br /> ❑ LIMITED WASTE HAULER TRAILER No.to be permitted <br /> ❑ 20+YARD BINS,DUMPSTERS,Roll-off&Other Containers No.to be permitted <br /> I hereby certify that I have pr pared this licati and t at the be t of my owledge it is tr and corre,t. <br /> / <br /> APPLICANT'S SIGNATUR X Title Date <br /> FOR DEPARTMENT USE ONLY <br /> Fee Is Due: ❑ ANNUALLY ❑ PER UNIT ❑ PER SITE ❑ EACH ❑ HOURLY ❑ Jan.1&Received By Jan.31 ❑ July 1&Received By July 31 <br /> REMIT <br /> BASE EXPLANATION BILLING REMITTANCE $ AMOUNT DUE CHECKED <br /> DATE DATE REMITTED AMOUNT <br /> FEE $60.00 81/82 7/10/81 Due. 8/1 O/E 1 <br /> FEE <br /> LESS <br /> PRORATION <br /> PLUS .�r�pr� [/r�� pp r� y <br /> PENALTY P-r...�F:71J.�UlJ,',. ;JS4�o:°,` - - �F� zft <br /> $70,00 X <br /> OTHER .i�) DAYS- <br /> O O <br /> OTHER 90 DAYS-12576 of BASE, <br /> Received by Date Receipt No. Permit Nos. Issuance Date Mailed Delivered <br /> A LICANT—RETURN ALL COPIES TO: ENVIRONMENTAL HEALTH PERMIT/SERVICES 1601 E.HAZELTON AVE.,P.O.BOX 2009 STOCKTON,CA 95201 <br />