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SAW J%N LOCAL HEALTH DIST ICT <br />1601 East Hazelton Awenwep P.D. Box 2009 <br />Stockton, California 95201 <br />- ' <br />»� <br />APPLICATION FOR <br />DISPOSAL SITE EXEMPTION <br />and <br />FEEDING OF FOOD PROCESSING AND PACKING WASTE <br />ADDRESS PHONE <br />ADDRESS PHONE <br />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 Assessor's Office): <br />' <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 />` <br />1. Duration of disposal (date -s). | <br />| <br />2 Turnover time for feeding of _ w 1 <br />3` site SeCurIt. {na+ura�Ltioundrie�� | <br />~^ ' <br />s) ^ -�------~-- <br />4' Type of waste to be fed or dumped a| the prsite ' <br />5 Estimate total i d � <br />, �� = <br />, per acre. 308+ «r"�� ��,��~~^�����t ~ <br />provide work plan tor applvInq w°s` .` `n |a/"| <br />Describe all <br />alternati*e szte� ,rid pI ]* 'h/ .oc�� <br />thjs c"ndit/^n <br />Vectur contro] prncedure1 .', <br />v' { <br />1 g,ee ' <br />ato pro.ide Oo/. °.o ' ecpI /e <br />�uthotion fom the k,tn H=n. tn ! <br />�he dumping o� any waste on this proper+y � <br />Signature of Property Owner - <br />Signa�ur� of Ope,�to, <br />Da te <br />Application fee of $140.00 due per site, per vear' <br />Application accepted with fee by <br />