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07/01/2003 15:52 20946 '433 FIFTH FLOOR PAGE 02 <br />FROM FAX NO. wen. 30 2003 04:34PM P2 <br />San Joaquin County Public Health Services <br />Environmental Heeith blvisi®n <br />ib Qdj0di WaatC M41n6gament Progra<rn <br />APPLICATt+CN FOR A € IMITED QUANTITY HAUUNG EXEMPTiON <br />To qualify for a "Umited Quanuiy Hauling m n" PUMUgnt tc ba "fit Wiu al W8M MatiagerneM Ae. the Billowing <br />candlUms must ba'met <br />The generator or health Cara j) Ma 'anal gen tee 140 than 20 pOurtds & m0dir2i waste per week, lrau porta tela <br />!hall 20 paurds of rnedIC81 waste at arty one times 01%Mllft a WacWng d=urnertt p Chapter 8, Chape, and the <br />generator or parent o(ganiraton has on ate one of ft flollowN., <br />1- Modkal Waste Meeagem+ant Flan if the gweratur or parent organtiadan to a lrge gandty ganeivtor or 0 0=11 <br />quantity generator reqs to i r pumtent to Chapter k <br />2- 1nftaM24bn Document if ft genwator or Parent a den is a savol quandLy generator rpt required to <br />regEster pursuant bn Chapter A. <br />PLEA319 COMPLM.- W !i MAIL WrrH $67 - TO; <br />San Joaquln County Pubic Health«-. <br />Environmental Health Dhpiqjon <br />Medical <br />304 F Weber Ave <br />Stockton, CA 96202 <br />Medical Waste Hauler Information <br />M Now C: Renwal <br />Mkicel OftWouaIrms Address.. P. 0. Box 1490 W.wr r s.!. <br />9'" Y f <br />5931 <br />Contwt Person: Chuck- Fee -ZC(2092M�_� <br />Staragsir's0ty Name: N/A <br />Storage Fadifty Address: <br />R r -ZIP . d <br />Pe Treatment <br />fawmmw Treatment Fadity <br />cw <br />List at employee naraas and Was suUmted to the Mediael Mwe. If nMt anough Boom, aftaw k%k=Mtiors. <br />I- marne: Mas carvautes Fide: Houaskeeping 9erv:Lce Worker <br />2 Name. vete '0 0M �e;�^�1 et rt <br />3. Name &Ulm Egant:e 'fie: •` o <br />,a <br />A copy o1 this onrcoan wW s ahaO be is em 's at an whom Imaworug nwdw +MWA. rrd <br />4ddlbon. W1 coplax of pi"q ( ww IgF kapc an AIR at gwamtoes or h"m c ionarg baft. <br />Applicant S;Zo <br />w i " <br />