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I <br /> APPLICATION <br /> SAN I AQUIN COUNTY COMMERCIAL AND IN STRIAL <br /> REFUSE COLLECTION LICENSE <br /> r 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 WASTE MANAGEMENT OF CALIFORNIA Phone 408-295-8544 <br /> 2. Business Address 2055 Gateway Place, San Jose, CA, 95110 <br /> (address) (city) (zip code) <br /> Waste Management of North America Oakbrook, Ill. 312-654-8800 <br /> 3. Owner(s) Name Home Address Phone <br /> 4. County or City Business License No. City Permit #4 , Cityof,St_Ozktc]� <br /> I hereby certify under penalty of perjury that the above informaz _te''and correct <br /> to the best of my know edge and belief. <br /> Dated: <br /> i <br /> onard Ste elli� Vice President <br /> FOR COUNTY USE ONLY <br /> A. DEPARTMENT OF PUBLIC WOFjKS <br /> ,( <br /> 1. Received by _ Date /O 2. Deposit Received Yes (At--No [ J <br /> 3. Financial Statement Received Yes No [ ] 4. Applicant holds current business <br /> license Yes *-I No • [ ] Do not refer to Health District until deposit and <br /> financial statement received. �� � 1 <br /> 5. Application Referred to Health District bye/< Date <br /> B. ANJO UIN LOCAL HEALTH /DIST,tICT <br /> 1. Re ive Date 4D- op°Q 2. Review and recommendation <br /> byt Applicant is (is not) able to comply with <br /> all applicable rules and regulations of the Health District and applicable pr ions of <br /> all County regulations and ordinances and applicable State law. Date <br /> 3. Application Referred to County Administrator Office by Date j <br /> C. DEPARTMENT OF PUBLIC WORKS <br /> 1. Received b 1J4,m vw or Date <br /> 2. Review and recommendation by Applicant has <br /> submitted proof of adequate workers' compe ation and caFualty insurance, the required <br /> financial statement, and payment guarantee deposit. Applicant is (mss 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: COS` A/SOUSA B <br /> REFUSE COLLECTOR'S LICENSE NO. <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 /> I and is issued for an indefinite period of time. <br /> I hereby certify that the above Order was passed and adopted on NOV 2 5 1986 , <br /> 19 , by the following vote of the Board of Supervisors, to wit: <br /> AYES: R R, COSTA, CAS1 LES, tall I L 6 <br /> r <br /> NOES: NONE <br /> ABSENT: NONE <br /> JORETTA J. HAYDE, Clerk of the Board of <br /> Supervisors of the County of San Joaquin <br /> State of California <br /> By Caroline Junco <br /> Deputy Clerk �� <br /> Copies to: COB; CAO; PUBLIC WORKS; HEALTH DISTRICT; AUD. ; LICENSEE <br />