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All <br /> AOL <br /> BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> A.R.Glover,M.D.,Pres. City of Tracy <br /> Patricia E.Vannucci,Secy. 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin County <br /> Anthonette Van Spronsen City of Escalon <br /> James Culbertson City of Lodi <br /> Earl Pimentel Stockton, California 95201 City of Manteca <br /> Fern Bugbee City of Ripon <br /> Daniel L.Flores (209)466-6781 City of Stockton <br /> William J.Wade San Joaquin County <br /> Mary Anna Love Jogi Khanna,M.D.,M.P.H.,District Health Officer San Joaquin County <br /> 1. Name of Applicant: 0 a t1.A. ,_ _ lJ <br /> Address: <br /> Phone: ci <br /> 2. Name of 24 Nr Contact Person: ®� y <br /> Phone:. _ _ <br /> 3. Name Property Owner: �� _ ,a <br /> Address: _ <br /> 1A NU 9Z PZ <br /> Phone: ci <br /> 4. Date Initial Haul: <br /> ^� - - <br /> -- <br /> 5. Type Waste Transported: <br /> 6. Type of Disposal Operation: r 0 ko ' <br /> { <br /> Land disposal operations will require proper ground preparation. Ground preparation <br /> shallinclude the removal of all weeds and organic matter that,might inhibit the <br /> - ' proper spreading and drying of liquid waste material . Proper spreading and drying <br /> of all waste material is important in order to prevent an insect nuisance. All <br /> debris mixed with the waste material must be removed and disposed of in a proper <br /> manner. <br /> 7. Provide a legible drawing with the following information: "j <br /> (a) Identify the dipsosal site location by address and the number of acres; <br /> to be utilized in the disposal operation`. <br /> (`b) Identify all wells, ponds, lakes, reservoirs, streams, drainage courses <br /> or/ 04r waterways within'2001 of the' proposed waste disposal site area. <br /> (c) Identify all residential dwellings within I mile of the proposed disposal <br /> site area <br /> gnu <br /> SEP 2619 b <br /> ENVIROmENI AL HEALTH <br /> 3 <br /> PERMIT/SERVICES 4 p <br /> N � { <br /> M <br /> ;;S ,8 <br />