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F81.1 <br />SAN JOAQUIN LOCAL HEALTH DISTRICT <br />1601 East Hazelton Avenue, P.O. Box 2009 <br />Stockton, California 95201 <br />APPLICATION FOR <br />DISPOSAL SITE EXEMPTION <br />and <br />FEEDING OF FOOD PROCESSING AND PACKING WASTE <br />P11! <br />AUG 1;, lqn,� <br />MEN <br />ENVIRONTAL 'HEALTH <br />PERMITISERVICES <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 />1. Identify the disposal site location, storage and/or <br />feeding areas and specify the (lumber 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 infor-troation: <br />Duration of disposal (datf's) <br />Turnover time for fel-.-dinq of wat.e. <br />Type of disposal site SeCLAr-lt, k fFrdc.Es. gat( -s. natural <br />boundries). <br />4. Type of waste to be fed or Jumptfd ,t the proloosed gate. <br />Estimate total q t-1 rk r Lr r 1 <br />per acre. <br />6. <br />r-rovide warI: plan for ap!,I', <br />D e: s c r .1. be 1 c lillt L n d:.- vi, <br />fal r- n A t j, v <br />,.A t I <br />�;ridi.t..il:r(a. <br />1. a (4 r t- i � (.-. p r o . L o (,- t h(- , b, . , , L 1 1 1 j <br />41 t ho c) t 1 Z a t t f r oir, t I i r H, <br />!(-°r"r- <br />he ri 4-j i <br />t <br />n 4aur <br />Siia e of Propertv <br />Owner .31.(j1iafdrF- f -"f Operator <br />Date <br />a to <br />P..Z <br />Application fee of $140.00 due per site, per vear. <br />Application accepted with fee by Date <br />