|
Application%Will Re Protested When SubmilOod Propvdy Compteled, Le Sura Tu Sitjrr T,r.i,Application.
<br /> APPLICATION
<br /> (For Non•Transferahin,'Aevoc0le, and SosponAritioj
<br /> ENVIRC}NME14TAL HEALTH PERMIT
<br /> LIQUID WASTE
<br /> ant: .1! s hor(1hy ma.. .)r',�t r•on p is I nes-e t110 ia:�sGlct+bn t1,9�(3 0{tr,i,r n 1, •:}; J/♦/
<br /> { ,,•'r, i.trf.p ??EIRE�]�!¢.��1. 'ic .(I a$�.,q, �.?,� 1..e-. 7 L AA,1rn 55 y �'( C� ✓�ry J _j' 'L L
<br /> f�nrl.ri��,..li,,,�`��'.�d^4.1A �!• i ��}'-�� - Ail iYrl55 .�,erC/J'LirC: �
<br /> m i•',lrtrler5, AUgt0.^,,is,2n,! Taic Pi,rne ,1mt7r!r5 '
<br /> i u:,ini+55 Teir•ghone N c. r
<br /> Yy.J dja�Jrr�L� FmCsgenCy ii!fr{ih C=rrc��n )--
<br /> C'an .actor LI-i-ncf:No 34,F+. -.
<br /> .rt n 1
<br /> 1)
<br /> At iGnntS tVi3r=.ti.'s lF•r. r. T1:1Q- l.,, i C.II�� tJ �C-' C,r-w I-'
<br /> Please Check Appi ci,bi®Cadry(1.7)and Fill In 1 d�ired Information
<br /> is PUMPER;VCHICLE P€RMIT REGISTRATiCIN(FOR EACH VEHICLE)
<br /> For July 1, Jtiha 30, 19 Disposal Sites
<br /> I)eaCrlptron[hAkerY(.,Color)
<br /> Semi No. CAL.License No. CAL t.ICFn!4e Flene*ill No.
<br /> Cana%ify Gni.Woighis R Measorem No
<br /> £tau;pmert.Adrkmg Andress
<br /> 2. C PLimm VARO
<br /> For July 1,....r._ ... June 34. 10
<br /> No.of Vehicios Stored _ .w.-_.... .......
<br /> NO „I C'),Rmical Tallels Stored, _.._..
<br /> 3. C PERCOLATION TEST.
<br /> A S or N.C.E N,mrwA S of R G.E. No
<br /> Tnffit Ds lc7/t lmey
<br /> 4. iGd'SAAdi"fATItSPv IPcRmiT // /j
<br /> j,j, eft:!'.,,J,s,. ^ �i (�/ • win. �
<br /> �)trr•.r •-+� � .,:.._ _...-- _. ... Address .. .. .. - - {- - - -
<br /> + SEPTIC TANK FF,_,j" CYSSPC LI LEACHING FIELD Z-surpAGE PIT © PACKAGE: PLAN,
<br /> taLRAAA NENT iTM'r TEMPORARY ®'`NEW © REPAIR ED C?THER
<br /> 5, ©.CHEMICAL TC 4.ETS Far July t,-,June 3o, 19
<br /> T pe Construei,on oisposal Seta
<br /> Pro- a: Unity .... Egtjipmenl Siorago'Cteaning Iocalion(s)
<br /> G. Z3 PACKAGE TREATMENT PLANT For July 1. -,Juni,,30, 19
<br /> operator Ni{rria . .. Where Certified
<br /> P4mt Location
<br /> Plant Capacity .__. . No Units Served
<br /> T. C LAUNDRY For Jul 1.-June 30, 19
<br /> July
<br /> t",IZF~ 0 Less Than 1.000 Sq. Ft.; 0 More Than 1,000 Sq. Ft.
<br /> 0,D-,f CLEANING,ChemicalsUsed/AmounUMo.
<br /> F�"t+�!^INra�r�ear!ced�.snt"s�ni+dsareaereN�es>:hal�:
<br /> Irriypcisrvl nersstob%carr}asuu,zcctaar4r3manscam :"Icerdlty fnia.'ha0 crrelanceetFhewer�iarrr srtrfhts Pim' IQ
<br /> £.an'�auo Fes- ur pPRFa1 r1n Iawe of 1�ItlL+cnia.' D ¢st R9.l>ftt t'1 n8t9Yegk rr«gypj;
<br /> iT w0-eorer�rrnp st4tculexe �Fit:re IPrO PuPla�We�: i ePrF3iy iSkNNt iR tRB�ilEYurin�!rte 4i I9t!aw rf?a�w^:; ,iy;�rn:i IS iSjur�',i 3!7;€II
<br /> N,9'1pI3'1'�rK3dri53:itA}Ptt'U 1rSric n>.9;r'6e;�mr78nS7(iOfl lswj,al Cull!i7ifl�.".
<br /> ! hr;ehy cortity gnat I have p.epmed this application ai,d that the work will ue done in iaccordancc wit�pan Joaquin Count;
<br /> prdman!m, state lows,and a'ises and re nil ns of lho-Sacs Joaquin Local t-teaiih District.
<br /> APPLIGANT'S SIGNA,UREx .._... __ .. i.✓�'L ''r e {i
<br /> FOR DEPARTMENT USE ONLY
<br /> Fees 16 Dt;e:0 ANNIJALi Y Q i'r 11 UNIT 4i r F it%M El1Crf ❑ Jrt,+il A,y 1 8,7.•r.r wn ly.lanu:i y:+ I3 idir 1&Nr•, 'Ay 01
<br /> I 1l Nli nrhllTTAN[:C f �Tq
<br /> I'.Xi`I.ANA'nON
<br /> Mrt�rOUNT U�'L I C'�1Ci�tF;)
<br /> VA.7€ I]AII' 7iEr') i Ahlt:ilr±T,
<br /> 1':.NAI 1r
<br /> it,,r,..•a 1•y ,a,a, - ien ,..:;q roil I .o..i r,, I.4,L i.. yn i,r M+4iin=t Fir�werhd
<br />
|