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ju" 41_"L_ "Q "a— . - - ....... <br />1601 East . <br />-tzelton LuAvenuev P.O. ox 20 <br />Stockton. California 95201 <br />APPLICATION FOR <br />DISPOSAL SITE EXEMPTION <br />and <br />FEEDING OF FOOD PROCESSING AND PACKING WASTE <br />1. 1 <br />r% <br />ENIVIRONMETAL HEALTH <br />PERMITINSERVICES i <br />311>1 <br />ADDRESS PHONE <br />A. Provide the following information on a scaled drawing not <br />less than I" = 600' (Parcel Maps that meet this requirement <br />are available at- the San Joaquin County Asse4s?r s Office): <br />I <br />1. Identify the disposal site location. storage and/or <br />feeding areas and specify the number of acres. <br />2. Identify all dwellings'"structures, wells, ponds, <br />lakes, reservoirs, streams, drainage courses, or other <br />waterways within 1000, of the proposed disposal site. <br />B. Provide the following additional information: <br />Duration of disposal ( dates j., <br />Turnover time for fer_dir®q of <br />Type of disposal site Seclirlt-v i fr_rcfE.__, <br />gat# -s, natural <br />boundries). <br />4. Type of waste to be fed or Jumped .if the- pr,fj.j_jse -.te. <br />• Cstimate total quortfstitv Ll <br />Per acre. <br />6. Provide wort plan f0t apjli <br />Descr-A.be :k <br />.-.0 tornatj vc- t I . <br />cA I t T a t: I ,, E- <br />CC AO <br />•Vic tier r on t r- c 1 <br />j. cA Li I e e j",1'? o L I i of <br />ItAtt"10t 1 t.,,ri f r om tht. Vii: !• ji-1414kil, i 4i, o-ij H,. I t t fit t i it I <br />ot .any wAst(-. j A,-, f t -i I, <br />2,na-LAre of Property (-jwner <br />f Oper ator <br />Da Date <br />Application fee of $140.00 due per site, per Vear. <br />Application accepted with fee by Date <br />G7/per <br />I %) <br />