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)( ii) VI'A 1�1I rAc:tl_IIN' PIA \1ITi:,:,:' A71C)N r,«„ <br />i Uil t N1 UIel1;MCNT AI:I:NCY USC ONLY <br />an' Joaquin Local Health District l_____ I.. <br />/•ISE NUMAI"R PT.NMIT NUM//!R <br />. nt1 r <br />an Joaquin I° <br />1I DAtR Af c[IvfD rlLlro.: TIES <br />rV .u" AtPLIcwI1.�N _ I �z -7 <br />i. DE <br />APr•t.1�ATION DATE ACCEPTE- _- WECE/►T NUK/R <br />LD [ <br />1. NU11LP uF t OR SUIWAST8. APP LICATIN FUR MbUIf IC ATION� <br />.r Pl•ll Al1UN �- ] P- IT Y® L_] OF PERMIT AU <br />I, AflLNU w!I.NTDATE P1.•R MIT 195000 CO SYt'MP RE P[AENC[ /,A GCj/r <br />1 f.Ti•I.ICATIGN S. wr .•I IC ATION fOR REVIEW <br />NO l Ihfs ftool hrs h(en dl•veloped tell mufhhle u>es. I1 is the ttartsmittai sheet for documents regrlired <br />to he "obnutted to the cnfolcement arlirwy. °A Roport of Station or Disposal Site Information <br />ul an anitrndloent fbcletu most be SublTntled with this form, <br />___.... ­_--._..._ -- -- ------ <br />NAME F FACILITY 1 <br />Ij French 'CampDisposdl _Site <br />LOCATION OF FACILITY (GIVE ADD RES* -Olt LOCATION DESCRIPTION BY SECTION. TOWNSHIP. RANGE, COUNTY --^—_ <br />! Section 22, T.1 -N, R6E (MD&B) <br />1 \ 1•L Of 1"A,ILITY <br />1 v <br />1 1 (111/Al_ J >1rllU v.AStk: OIDPO�AL !,IT.' ( , T . RANS$ ER/P ROCE941NG STATION (INCLUDes /111SOUKC_E _RECOV.C"Y) <br />__.. <br />.- _..• .... .. _ . ..__ <br />I I," of WAST(./ 70 RE RECEIVED <br />Irl S,. 1. 11.1 II/N <br />I , WLSIOLF111AL REPll9[ ) LUN%t"ULIIUN/DLMOLITION WASTES HAZARno OS WASTES <br />uV <br />I ht r( by rcknowledge that I have read this application and the Report of Station or Disposal Site Info/ma- <br />,tllrl (vrlifi,, that the information given is true and accufate to the hest of my knowledge and belief. <br />ir.:,ttlno the solid waste facility. 1 agree to comply with the conditions of the permit and with state <br /><t-ui local enacinrents. <br />. r. .. 1, ,.t /ll ./. 1+T' � � bi4NA rUR lPC AtOW AGDo CNp" <br />.. 1- r.w F _. TTPFO AM[ <br />Gerald Dave Phil iani <br />PATE TITS[ <br />Giambast <br />. -. ­_ ._ _ _. _ _1.. U <br />- - wT[ <br />CITY MANAGER I partner, J. Giambastiani $ Soni <br />i <br />a"I a.K At RUPHIAIF_ HOA •-� � _ -__-- <br />Are lrL A71UN pPC.OVEO �'•�. AF►LIL A4ION t. f, N.e-n <br />wall NCY .. - ..... .. __ <br />bl"NAIURE TITLE AND 1"114 U NAM[ DATE AND TELLPNONE NO. <br />USL ONLY I A <br />rIATr /:r-a.1:1VLO I Ct/l'CK A/'PHpi'NIAT/' ®OK <br />t\'A STE <br />AI. Aa. 1. KII NT <br />I <br />t U A N O <br />0%f ONLY <br />P l <br />1 i_jPH'( <br />CVMMLRCIAL SOLID WASTES <br />�.� 9r:WAUF_ SLUDGE <br />L� AGRICULTURAL WASTES <br />' TINS/ <br />t LIQUIDS/SLURRIES <br />SEPTIC TAN-1PUMPINGS <br />' oTl,! R ISPt CIitll. �` �/%Ji. .., <br />_ - - Cd <br />e.�':C 'op <br />11, <br />a 1'L.ATION <br />°'EP FVCTIV�_ <br />PROPOSED CHANGE <br />(CHECK ONE OR VO4N) <br />f AFFECTIVE <br />OAPE <br />/ wl ISI I Y <br />INt rPiMA71L)N <br />� --j f D®4'Y' <br />WILL COMMENCE + ! <br />(� <br />U DESIGN <br />I <br />OPERA410M <br />I <br />f <br />1 OWNER OF PKCPERTY (NAM[( <br />I ADDRCS/ <br />City of Stockton <br />iCi.ty Hall, Stockton, CA <br />95202 <br />111 <br />1 OI'LNA7VR (VAMP' <br />.1 AOOwC// <br />- <br />'..,.•ATtN <br />John Giambastiani & Son <br />1155 W. <br />Mariposa, Stockton, <br />CA 95204 <br />A!•li 1.11..5 Nl.l 1.E t.1. 011. NO11C1. MAY <br />City Clerk, City of Stockton, <br />Irl' blRV1.0 <br />City Hall, <br />Stockton, <br />CA 95202 <br />t - <br />tr 1l INt. i L C LNCLt:BLD <br />IV, <br />i S <br />I ht r( by rcknowledge that I have read this application and the Report of Station or Disposal Site Info/ma- <br />,tllrl (vrlifi,, that the information given is true and accufate to the hest of my knowledge and belief. <br />ir.:,ttlno the solid waste facility. 1 agree to comply with the conditions of the permit and with state <br /><t-ui local enacinrents. <br />. r. .. 1, ,.t /ll ./. 1+T' � � bi4NA rUR lPC AtOW AGDo CNp" <br />.. 1- r.w F _. TTPFO AM[ <br />Gerald Dave Phil iani <br />PATE TITS[ <br />Giambast <br />. -. ­_ ._ _ _. _ _1.. U <br />- - wT[ <br />CITY MANAGER I partner, J. Giambastiani $ Soni <br />i <br />a"I a.K At RUPHIAIF_ HOA •-� � _ -__-- <br />Are lrL A71UN pPC.OVEO �'•�. AF►LIL A4ION t. f, N.e-n <br />wall NCY .. - ..... .. __ <br />bl"NAIURE TITLE AND 1"114 U NAM[ DATE AND TELLPNONE NO. <br />USL ONLY I A <br />rIATr /:r-a.1:1VLO I Ct/l'CK A/'PHpi'NIAT/' ®OK <br />t\'A STE <br />AI. Aa. 1. KII NT <br />I <br />t U A N O <br />0%f ONLY <br />P l <br />1 i_jPH'( <br />PO ED IP %., <br />[� 1 .UIP U'rl'L ►L "MIT <br />I • .LNCtl DENIAL UPHELD <br />TITLC AND PRINTED NAM[ VATS ANO 1FLLF1UNE NO. <br />