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P,5-ke Is pk� Rle R aoz s <br />Busin`Licence�vey C-(.OqMc."J-pec, <br />i <br />I. Does the business handle Hazardous Material? Pis(z� �a�g��f6s33< <br />a. Type <br />b. Amount <br />2• Does the business generate Hazardous Waste? <br />a. Type p <br />b. Amount generated per month, <br />c. EPA ! <br />d- Storage method and time stored on premise. 30 <br />e. Waste disposal method, s„�C-ui,-S, C` mic.�G o2 <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 i <br />e• Other <br />4. Type of sewage disposal system. <br />a- Private Septic C.O . M• <br />Under Sanitation Permit # <br />b. Public Sewer <br />Name of System <br />City Discharge Permit # <br />S. Type of Water Supply <br />a. Public <br />Name of System <br />b. Private Well Permit ! <br />Number of Employees <br />Distance from septic system(s) <br />Distance from Undergrounq Storage Tank <br />Distance from Hazardous Material Storage <br />Distance from Hazardous Waste Storage <br />4-18-86 <br />RLV <br />