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c, <br /> r <br /> SAN JOAQUIN COUNTY <br /> PUBLIC HEALTH SERVICES <br /> ENVIRONMENTAL HEALTH DIVISION <br /> 304 EAST WEBER AVENUE, P.O. BOX 304 <br /> STOCKTON, CA 95201 <br /> APPLICATION FOR ANNUAL EXEMPT DISPOSAL AREA PERMIT <br /> FOR APPLICATION OF CANNERY WASTE TO LAND & <br /> FOR ANNUAL ENVIRONMENTAL HEALTH PERMIT FOR ANIMAL FEED YARDS <br /> SITE ADDRESS PARCEL NO. <br /> NAME OF PROPERTY OWNER: <br /> ADDRESS: TELEPHONE NO. <br /> NAME OF OPERATOR: <br /> ADDRESS: TELEPHONE NO. <br /> NAME OF HAULER: <br /> ADDRESS: TELEPHONE NO. <br /> A. Provide the following information on a scaled drawing not less than 1"=600' <br /> (Parcel Maps that meet this requirement are available at the San Joaquin <br /> County Assessor's Office): <br /> 1. Identify the soil amendment/stabilization or feed yard area and specify <br /> the number of acres for application and the total size of the property. <br /> 2. Identify all dwellings, structures, wells ponds, lakes, reservoirs, <br /> streams, drainage courses, or other waterways within 1000 feet of the <br /> proposed application site or feed yard. <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 to be applied or fed at the proposed site. <br /> 5. Estimate total quality of waste applied In tons per day and per acre. <br /> 6. A work plan for applying waste to land. <br /> 7. Depth to ground water and soil types on site. <br /> 8. Turnover time for feeding of waste. <br /> 9. Vector control procedures. <br /> 10. Drainage system at cannery waste storage area. <br /> I agree to provide the above information and I must receive authorization from San <br /> Joaquin County Public Health Services prior to operation of this site. <br /> Signature of Property Owner Date <br /> Signature of Operator Date <br />