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STATE OF CALIFORNIA - SOLID WASTE MANAGNMENT ODA** <br /> SOLID ST FACILITY PERMIT APPLICATION <br /> A WMN E-1-77 (NSW 9-77) <br /> FOR ENFORCEMENT AGENCY USE <br /> San Joaquin Local Health District FILE MUNGER jPKRMIT RUNNER <br /> eauaTY <br /> San Joaquin County DATE RNCE/Y D FILING FUN <br /> ' .PE OF APPLICATION <br /> I.APPLICATION DATE ACCEPTED RReNIPT NUM A <br /> 1.NOTICE or P as tD WASTE I.APPLICATION FOR MODIFICATION <br /> OPERATION P PANNI * OR PERMIT <br /> 11 <br /> A.AMENDMENT DATE PERMIT HISU O OO SWMP RNFERENCN PASS S <br /> OF <br /> Li APPLICATION S. APPLICATION FOR REVIEW <br /> NOTE: This form has been developed for multiple uses. It Is the transmittal sheet for documents required <br /> to be submitted to the enforcement agency. *A Report of Station or Disposal Site Information <br /> or an amendment the' to must be submitted with this form. <br /> Lovelace Transfer Station <br /> -•: LOCATION Or rwciLiTV G/vE wDORRSS @R LOCwTrON Dnscfti 1aN RY SECTION,TOWNSHIP.RANGE,C4U Y .- <br /> On Lovelace_Road <br /> TYPE QF FACILITY— <br /> SOLID WASTE DISPOSAL SITE XI TRwasrNR/PROCaSING ATION(IN . <br /> CLUDNS RE URGE RECOVERY <br /> SNERAL TYPE OF WASTES TO 88 RECEIVED <br /> 09SCRIPTION j <br /> II RESIDENTIAL REFUSE CONSTRUCTION/011MOLITION WASTa 13 HAZARDOUS WwarEs <br /> OF <br /> i <br /> FACILITY COMMERCIAL SOLID WASTES SEWAGE SLUDGE AGRICULTURAL WASTES <br /> TIRE$ LIQUIDS/SLURRIES SEPTIC TARN :..' <br /> OTHER $PNOrrY <br /> II. <br /> I OPERATION I rNCTt PRO° SED CHANGE (CRACK ONE OR ROTE) I a rE IVU <br /> DATE DATE <br /> 1 F ACILI T ON X COMMENCED 'FILL caMMNMCE 1 7-1-77 DESIGN arE ATIaN _ i <br /> OWNER or r arERTY NAM __ -- I ADDRESS <br /> San Joaquin County i P.O. Box 1810, Stockton, Ca. 95201 <br /> Or RATOR aAitE I ADDRESS <br /> OPERATOR San Joaquin County Dept. of 'Public Works I P.O. Sox 1810, Stockton, C . 95201 <br /> I <br /> 161PORMATION ._ <br /> ADDRE WHERE LEGAL NOTICK MAY UK SERVED <br /> 1810 E. Hazelton Avenue, Stockton, CA 95205 <br /> FILING PEE ENCLOSED <br /> IV. <br /> s <br /> I hereby acknowledge that I have read this application and the Report of Station or Dis' sal Site Informa- <br /> tion, and certify that the Information given is true and accurate to the best of my knowledge and belief. <br /> In operating the solid waste facility, I agree to comply with the conditions of the permit and with state <br /> and local enactments. <br /> SIGwTtlRta -0 4 ET armawT R ATOM ON AOR <br /> TAPED NAME TYPED His& <br /> C.E. Dixon W. Cyph r <br /> rt.X DATE TPP DAYS- <br /> County Administrator Maintenance Superintendent '® 7 <br /> CHECK APPROPRIATE DOX <br /> "FORCEMENT <br /> AGENCY APPLICATION APPROVEDAPPLICATION.DENIED <br /> SIGNATURE TITLE AND PRINTED NAME DATE AND TE6EP NN Na. <br /> USK ONLY <br /> DATE RKESIVED CHECK APPROPRIATE BOX <br /> LID OR,IT TO <br /> WASTE <br /> nou SSD IT <br /> PRONCSND PERMIT AGENCY DENIAL UPH19LO <br /> MANAGEMENT <br /> El NOAND aCt T <br /> tISE ONLY SIGNATURE W TITLE AND PRINTED NAME DATE AMU*11LOPINAW9 NO. <br />