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:•ii iir::::'v:•rir:L:4 <br /> .•:;Y:::..::g: <br /> � ■ 1 4 <br /> ii:•r::::fiij2}�ii iii:riiisit:•:ri:ji:iiir:i:i'S>'rli■:iii�S}::•isr:.:.i::%�:::::::::<}�Yr::?i::ir:i?i^:•i:6i:v:?:�'i::.:.r:i':•r�:.....:::n:: <br /> swi; <br /> ii},`.i::,:?::?;'};:;;:;:;:i:?:i '':,:';i..•.:!i?:•r:v'C!:•:::v:{.:.:, :.::::::v:.:�::.:�:•::.r•::•.,:y:..,, :....::::::...:•::.::•.t;::••{::•:.�.:.,.�:.::•'..... .::...:........:. .:.....: •: ;'::i::"r::::::::r::::J::t::vJ:::i:j;::::::::::•:•:::::?:: <br /> :;::•rii::;. <br /> :<::%::is::irS:;Citi:is6::::i::r:::i:t:i::i:<::<::^::::�:;;:�;:i:::::i:::i:i:%i:�i ii:ii:i>iii::c.::::::::iiri}isi::i::£:•J.ii::ii::::is?::2§§�iiii::.`;;siiSiiiSiiSi:::::iii::ii:}Si:?iii::;ii;:'.•::•::::i:::::iiii5::::;i ii:i:S iii:<::::::$:::....... .pc. .... .....::::::.�. <br /> SITE ADDRESS: <br /> 30703 a c X r T/► yr /,/ , %tU y Cit 1?5--? 7 6 <br /> NAME OF PROPERTY OWNER: TELEPHONE: <br /> r,-,'c V /`1g7e-ic7/ 4 e cov«y Sdif `gSTc <br /> ADDRESS: 4i'i s Co- z <br /> yam-C � <br /> NAME OF HAULER: TELEPHONE: <br /> rirefc e�lS eye? Scr vace <br /> ADDRESS: <br /> Provide the following Information on a scaled drawing not less than one Inch equals six hundred <br /> feet (1"= 8001. <br /> • Identify the disposal site location,storage and/or feeding areas and specify the <br /> amount of acreage. <br /> • Identify all dwellings, structures,wells, ponds, lakes, reservoirs,streams, drainage <br /> courses, or other waterways with one thousand feet (1,0001 of the proposed <br /> disposal site. <br /> NOTE: Parcel Maps that meet this requirement are available at the San Joaquin County <br /> Assessor's Office. <br /> Provide the following additional Information: <br /> • Duration of disposal (dates). <br /> • Turnover time of feeding of waste. <br /> • Type of disposal site security (fences/gates/natural boundaries). <br /> • Estimate total quantity in yards or tons per day and per acre. <br /> • Provide a work plan for applying waste to the land or work plan for animal feed. <br /> • Describe all contingency plans for selecting alternative sites and provide the <br /> location of all alternative sites should weather conditions warrant this condition. <br /> • Vector control procedures for storage of waste. <br /> 1 agree to provide the above Information and 1 must receive authorization from Um San Joaquin <br /> County Public Health Department, Environmental Health Division prior to the dumping of any waste <br /> on this property. <br /> SIGNATURE OF PR OE TY OWNER: DATE: <br /> SIGNATURE OF OPERA DATE: <br /> %Vu LI ��-4 J14� -�- - -)1'� <br /> APPLICATION ACCEPTED WITH FEE BY: DATE: <br /> (Application Fee of$790.00 Due Per Site) <br />