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SAN JUAIIUIN LULAL �ALIH DISTRICT ��Z s 1,;4)� <br /> • ENVIRONMENTAL HEALTH DIVISION • u/rj ;:,`l 3. <br /> vx,, C A . <br /> Business Licence SurveyQQ ��J�, <br /> 1. Does the business handle Hazardous Material? AJIA <br /> a. Type <br /> b. Amount <br /> 2. Does the business generate Hazardous Waste? �Vllq <br /> a. Type <br /> b. Amount generated per month. <br /> c. EPA # <br /> d. Storage method and time stored on premise. <br /> e. Waste disposal method. <br /> 3. Is the business presently under any Permits? <br /> a. State Permit # <br /> b. CRWQCB Discharge Requirement # <br /> c. City Permit # <br /> d. County Permit # <br /> e. Other <br /> 4. Type of sewage disposal system. <br /> a. Private Septic ✓ <br /> Under Sanitation Permit # <br /> b. Public Sewer <br /> Name of System <br /> City Discharge Permit # <br /> 5. Type of Water Supply <br /> a. Public I/ <br /> Name of System <br /> b. Private Well Permit # <br /> Number of Employees / <br /> Distance from septic system(s) It-A <br /> Distance from Undergroung Storage Tank ti/A <br /> Distance from Hazardous Material Storage /v//f <br /> Distance from Hazardous Waste Storage A114 <br /> Fiz <br /> 4-18-86 <br /> P,LV <br />