Laserfiche WebLink
I - <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />ENVIRONMENTAL HEALTH DIVISION <br />Business License Survey <br />1. Does the business handle Hazardous Materia? <br />a. Type o o6 �2�u}f�rf yAum./c <br />b. Amount Bode, ,�5 ,2p0 5c (1°,u <br />2. Does the business generate hazardous Waste? <br />a. Type o&Kusa rN.ek (NCO -J, <br />gdooq OW 4. <br />b. Amount generated per month 6rouxol 14o /,40o9 fs ti <br />C. EPA # Q� <br />d. Storage method and time stored on premise <br />e. Waste disposal method. petf,/e?'Dn) of j P,-#ery-el',C <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 #Ej <br />e. other $ foru�e�l(u 4(r rla� - <br />Lir�ua(f! <br />�9.J Type of sewage disposal system <br />a. Private Septic <br />(wLK5 � <br />�nder Sanitation Permit-{{� <br />b. Public Sewer ---- - RY� <br />l�z aG <br />Name of System <br />i <br />City Discharge Permit # <br />r5 -Type of Water Supply <br />a. Public <br />Name of yf m <br />�ivate WellPermit <br />Number of Employees 3'Z <br />Distance from septic system(s) 2-400'f <br />Distance from Underground Storage Tank <br />Distance from Hazardous Material Storage <br />Distance form Hazardous Waste Storage <br />EH 00 10 (4/86) <br />