Laserfiche WebLink
Working for YOU 1 r K <br /> San Joaquin County Household Hazardous Waste Facility <br /> t Date: •1 7r l \ IU f 1 5 w� <br /> Z Name: ✓ <br /> Address: <br /> City: . Zip: <br /> 3. Inside City Limits Outside City Limits (check one) <br /> I hereby swear that the waste I am deliverying today was generated in San Joaqin County by a <br /> residence and not in a business endevor. Business waste is a waste generated in the course of <br /> 4' doing business, even if that business is operated out of your home. Business waste also includes <br /> waste generated by churches, schools, government agencies, non-profits, property management or <br /> apartment com lex mana ent, for profit ranches and farms and stroage companies. <br /> Signature: <br /> 5. 1 am delievering waste from # households today. <br /> 6 1 have used the Household Hazardous waste Collection Facility # <br /> 7 1 hearout t i ogram t ugh the followi (circle an that apply) <br /> Household <br /> Hazardous Waste <br /> Brochure <br /> Recycling Guide/ <br /> Phone Book Website <br /> i <br /> � • _: -= Flyer/Mailer <br /> Newspaper Ad/Article Called Solid Waste <br /> name 468-3066 <br /> Other: <br /> (describe) <br /> Word of Mouth <br /> Official Use Only Lia Bus vn <br /> t <br />