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APPUCATION FOR LJOUID WASTE PERMIT
<br />SAN'JOAOUIN COUNTY PUBLIC WEALTH SERVICES
<br />ENVIRONMENTAL HEALTH DIMION
<br />P.O. BOK 388, 4" Ill. SAN JOAOUIN ST., STOCKTON, CA 8620143$$
<br />(201) 48/.3420
<br />80M*100 DABU PRIM E%Pifft 1 MR F100 DATEijffl
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<br />APPUCATP7% 10 HMOV AIAOS TO THE SAN JOAOU6/ COVNTV FOR A PEMYADT TO CONSTW4CT ANO.KDA WSTALL T"E 4V0IK DE4CPAIED. "APKlCATWN to MA" IN COMPLV.WA WFTH SAN
<br />,X,AC/AN COUNTY MWWPk*W TITLE, CHAFFER $•1110.3 AND THE $TANOAMS Of WAN JOAOUIN COUNTY PUEL.YL HtXTH i MIKES, *WVw aQNVAL #EALTR OYVIOOii.
<br />J06AWAISSXJAA000_...1.2650 F. Ra T'Ti'Y T,n C- k i _wT&a 4 aces
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<br />CON'I'riACTOR Mprtaxt.._ eptf.c .tdyOAE(k i2i B. Churchill Stkj A 444225 463-5343
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<br />t6YTIC TANKICNiCASS TRAP0 TYPCIMFO_.....-._......._ ........_._.. CAPACITY NO. COMPART 0110
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<br />I HEfAkY CfRTIPY T"AT i HAVE PREPAREO TN46 APPUCATKYN ANO TNAT THE WORK MALL bt OONC M ACCAct vwm SAN JOAWKN COUNTY OPOWAXICtb ANO STATE LOWk AND V""
<br />ANO IEOUL.ATA7NS OF T"E SAN JOAOUN COUNTY, NOW OVA"OR ucat ETI 44ENT'6 dMI"ATUIE CLT VMS THE fOL10WN0:'I"PITRYTNATN THE mwommANCE Of -114 WOW PORRMICH
<br />TWA PENAYT IS AWM. I *"ALL NOT EMPLOY ANY PERSON N AM" A MANN" AS TO SEf.OW W"L-Y TC VIOW-JAN'S COMPENSATION LAWS Of CALWOM".' *""LACYEI" EMIN6 ON
<br />SUS-COW%&C, TIW U&NATUAt CEKnf" TRC fOLiOVV*O: 'I CERYNY T N THE PEPPORMA ICE OF TIME WOW FOA VWXH THAI P010" O t66t OO, I ("ALL VAPLOY P WiON1 SUGJWT TO
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<br />I. NAMES Of 6TYS'£T$ ORR0AO6 NEAREST TC OR i0UW004 TRE PADrMT, J. LOCATION Of "OWE 6tWA" Gtwv*Ai Waft" OR "wmaw
<br />2. 00TUNT 00 114 MOPE". VVITN OMAE'NWONS AND NORTH TANECTWN. ""'"NON Of "WA." ONM"LriAb. 6VIEtEMS.
<br />J OIMEk4WNbb OMLSKS AND LOCATION OF ALL EXWTNC AND APIOPOSED STM/CTWWA, i, LOCA'fDOM Of YPEi.E.i Utiff116t IIMIE7tUS LIf ONE /6fM16AEEA f6'TY fT. Oh
<br />WCLUOING CAVEAEO ANEAS WICK AS FAY.04, OMPAWAYM ANO WXX6 TRE PAOPHO'Y OR AbJOS6N6 PAO#VWI .
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<br />PAIMENT
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<br />An 13 1995 '
<br />SAN JOA?'di1iN C ;v�Ntt
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