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* APPLICATION <br /> SAN J... IN COUNTY COMMERCIAL AND INDU.. AL <br /> ® REFUSE COLLECTION LICENSE <br /> THIS APPLICATION MUST BE ACCOMPANIED BY (1) A CASHIER'S CHECK OR IRREVOCABLE LETTER OF <br /> CREDIT IN THE AMOUNT OF $5,000.00 AS A DEPOSIT PAYABLE TO SAN JOAQUIN COUNTY AND (2) AN <br /> AUDITED FINANCIAL STATEMENT OF APPLICANT'S OPERATIONS <br /> (Please print or type) <br /> 1. Business Name Modesto Disposal Service Phone (209) 538-2210 <br /> 2. Business Address 2769 W. Hatch Rd, MpdPRtn_ CA 9535 _ <br /> (address) (city) (zip code) <br /> 3. Owner(s) Name �er�1� L. Stpkps Home Address 512 Phone 577-8670 <br /> Greenwich Ln. <br /> 4. County or City Business License No. City of Manteca #1Q067 <br /> I hereby certify under penalty of perjury that the above information is true and correct <br /> to the best of my knowledge and belief. f <br /> Dated: � <br /> Ron C. DeLong-General Ma er <br /> ---------------------- <br /> FOR COUNTY USE ONLY <br /> A. DEPARTMENT OF PUBLIC WORKS <br /> W" �fi as �r � �" <br /> 1. Receive D to I Z 8 2. Deposit Received Yes vl No [ ] <br /> 3. Financial Statement Received Yes j,- No [ ] 4. Applicant holds current business <br /> license Yes No [ ] Do not refer to Health District until deposit and <br /> financial statement received. <br /> 5. Application Referred to Health District b Z7 'yV Date <br /> B. SAN JOAQUIN LOCAL HEALTH DISTRICT <br /> 1. R iy Date -�a•� 2. Review and recommendation <br /> b « Applicant is (' ) able to comply with <br /> all applica a rules and regulations of the Health District and applicable provisions of <br /> all County regulations and ordinances and applicable State law, ate la—19- S& <br /> 3. Application Referred to County Administrator Office by Date —19W <br /> C. DEPARTMENT OF PUBLIC WORKS <br /> 1. Received by ' s'Js•. 49 - �7E 1-6, 'tic Date <br /> 2. Review and recommendation by Ig Applicant has <br /> submitted proof of adequate workers' compen ation and caFualty insurance, the required <br /> financial statement, and payment guarantee deposit. Applicant is tis not) able to comply <br /> with all applicable rules and regulations of the Health District and applicable provisions <br /> of all County regulations and ordinances and applicable State law. Applicant should <br /> (should not) be issued this License. <br /> BOARD OF SUPERVISORS, COUNTY OF SAN JOAQUIN, STATE OF CALIFORNIA <br /> MOTION: SOUSA/WILHOIT BC2 1 <br /> - - <br /> REFUSE COLLECTOR'S LICENSE NO. T <br /> POST IN A CONSPICUOUS PLACE <br /> A license to collect and transport commercial and industrial refuse within the unincor- <br /> porated area of the County is hereby issued to <br /> This Board Order shall constitute such license. The licensee shall conduct its operations <br /> under the license in accordance with all applicable local ordinances, rules and regulations <br /> and State law. This license is subject to revocation by this Board, is non-transferable, <br /> and is issued for an indefinite period of time. <br /> I hereby certify that the above Order was passed and adopted on January 20th , <br /> 19 , by the following vote of the Board of Supervisors, to wit: <br /> AYES: WILHOIT,COSTA,SOUSA,BARBER <br /> _e <br /> NOES: NONE <br /> ABSENT:NONE <br /> JORETTA J. HAYDE, Clerk of the Board of <br /> Supervisors of the County of San Joaquin, <br /> S6.u, to of California <br /> EY 1A I HAYN (SEAL) <br /> Deputy Clerk <br /> Copies to: COB; CAO; PUBLIC WORKS; HEALTH DRICT; AUD. ; LICENSEE <br />