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Application- No. <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 E. Hazelton Ave., P 0 Box 2009 <br />Stockton, CA 95201 <br />APPLICATION FOR <br />DISPOSAL SITE EXEMPTION <br />and <br />FEEDING OF FOOD PROCESSING AND PACKING WASTE <br />NAME OF PROPERTY OWNER J, PV1 . D/41 k` <br />ADDRESS L. F1'eNCH CXW(p pot , /QAtQTE-(__1A, C q!S73 PHONE C( )-1_1Z'2 <br />- <br />NAME OF OPERATOR 'J, Aj, 1) A ( k) V <br />ADDRESS 1 9 f Fqff,,CH CX)1L,W k0,4 k1A1,276_6,A1 CA, PHONE C182-11 7Z"-)- <br />� v <br />NAME OF HAULER V, k', Lp a L <br />E. <br />a <br />4 <br />A. Provide the following information on a scaled drawing not less than 1"= <br />6001 (Parcel Maps that meet this requirement are available at the San <br />Joaquin County assessor's Office): <br />1. Identify the disposal site location, storage and/or feeding areas and <br />specify the number of acres. <br />2. Identify all dwellings, structures, wells, ponds, lakes, reservoirs, <br />streams, drainage courses, or other waterways within 10001 of the prop- <br />osed disposal site. <br />PAYMENT <br />B Provide the following additional information: RECEIVED <br />8. Vector control procedures for storage of waste. <br />I agree to provide the above information and receive authorization from the <br />San Joaquin Local Health District prior to the dumping of any waste on this <br />property. <br />operty <br />�A/ I D�WY <br />0y, <br />Sig n lakure of Property Owner Sign*t`ure of Operator <br />Date -7 / ZI qla Date <br />Application fee of $140.00 due per site, per year. <br />Application accepted with fee by <br />1. <br />Duration <br />of disposal (dates). <br />JUL <br />2 11988 <br />2. <br />Turnover <br />time for feeding of waste. <br />3. <br />'-,Type of <br />disposal site security (fencest <br />gates,(.ENV1t <br />4. <br />5. <br />---\Type of <br />Estimate <br />waste to be fed or dumped at the <br />total in <br />prop6sedpYSER <br />VOe. <br />6. <br />Provide <br />quantity yards or tons <br />per day and <br />er <br />work plan for applying waste to <br />land. <br />-4 <br />71 <br />Describe <br />all contingency plans for selecting <br />t4ng alternative <br />sites and <br />provide <br />the location of all alternative <br />sites should <br />weather conditions <br />warrant <br />this condition. <br />8. Vector control procedures for storage of waste. <br />I agree to provide the above information and receive authorization from the <br />San Joaquin Local Health District prior to the dumping of any waste on this <br />property. <br />operty <br />�A/ I D�WY <br />0y, <br />Sig n lakure of Property Owner Sign*t`ure of Operator <br />Date -7 / ZI qla Date <br />Application fee of $140.00 due per site, per year. <br />Application accepted with fee by <br />