Laserfiche WebLink
i <br /> SAN JOAQUIN COUNTY PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 445 N. SAN JOAQUIN STREET, P.O. BOX 2009 <br /> STOCKTON, CA 95201 MAY 2 6 1 <br /> 992 <br /> (209) 468-3420 <br /> ENVi <br /> APPLICATION FOR ANNUAL EXEMPT DISPOSAL PE IT/S <br /> FOR APPLICATION OF WASTE ASH OR SLUDGE TO LAND <br /> SITE ADDRESS: 2450 W. Yosemite Avenue Manteca, Ca.pARCEL N0.241-300-47,48,49,50 & <br /> NAME OF PROPERTY OWNER: City of Manteca 241-310-16,18,32,44,48,52,53,54 <br /> ADDRESS: 1001 W. Center St. Manteca, Ca. PHONE: (209) 239-8460 <br /> NAME OF OPERATOR: City of Manteca <br /> ADDRESS: 1001 W. Center St. Manteca, Ca. P11ONE: (209) 239-8460 <br /> NAME OF HAULER: City of Manteca / Lessee <br /> ADDRESS: 1001 W. Center St. Manteca, Ca. PHONE: (209) 239-8460 <br /> A. Provide the following }nformation on a scaled drawing not less than 1"=600' (Parcel <br /> Maps that meet this requirement are available at the San Joaquin County Assessor's <br /> Office): <br /> 1. Identify the soil amendment/stabilization area and specify the number of acres for <br /> application and the total size of the property. <br /> 2. Identify all dwellings, structures, wells, ponds, lakes, reservoirs, streams, <br /> drainage courses, or other waterways within 1000 feet of the proposed application <br /> site. <br /> B. Provide the following additional information: ' <br /> 1. Duration of disposal (dates). <br /> 2. Site operation hours and days. <br /> 3. Type of disposal site security (fences, gates, natural boundaries). <br /> 4. Type of waste ash or sludge to be applied at the proposed site. <br /> 5. Estimate total quantity of ash or sludge applied in tons per day and per acre. <br /> 6. A work plan for applying ash or sludge to land. <br /> 7. Depth to ground water and soil types on site. <br /> I agree to provide the above information and receive authorization from San Joaquin County <br /> Public Health S ' es prior to the spreading of any waste on this property. <br /> Signature of Property Owner Signa of Operator <br /> Date: S~ ?—c� Z Date: 5/ / <br /> Permit/inspection fee of$140.00 due per site, per year. <br /> Application accepted with fee by Date <br /> f <br />