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BOARD OF TRUSTEES SAN JOAQUIN LOCAL HEALTH DISTRICT SERVING <br /> A.R.Glover,M.D.,Pres. City of Tracy <br /> Patricia E.Vannucci,Sec'y 1601 East Hazelton Avenue, P.O. Box 2009 San Joaquin Count' <br /> Anthonette Van Spronsen City of Escalon <br /> James Culbertson Stockton, California 95201 City of Lodi <br /> Earl Pimentel City of Manteca <br /> Fern Bugbee City of Ripon <br /> Daniel L.Flores (209)466-6751 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 Appl icant: Z I '1-X L- L) ,-.v _ <br /> Address: A-) 1 y.,-f3 rZAtja <br /> Phone: �-d `f - 4 (;_3 �- 9yv � <br /> 2. Name of 24 Hr Contact Person: 'T i AA I <br /> Phone: b c( - '-1-78 , 3�= -- <br /> 3. Name Property Owner: J T-:� A 1.4 C fel L _r C A -r r L )E <br /> Address. l U 71 1��, s_i-1 r-- L '1` O iq <br /> Phone: G ci - --- <br /> 4, Date Initial Haul : J� 1 el <br /> 5. Type Waste Transported: A r0. 'Fri a `;ZA1' _L-r C �___ <br /> 6. Type of Disposal Operation: ZaC�_'-Pi r <br /> 5 <br /> E <br /> i <br /> Land disposal operations will require proper ground preparation. Ground preparation <br /> shall include 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: <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 other waterways within 200' of the proposed waste disposal site area. <br /> (c) Identify all residential dwellings within l mile of the proposed disposal <br /> site are. <br /> -SEP 2 6 198 <br /> ENVIRUMb? TAL HEALTH <br /> FERMIT/SERVICES <br /> `k7 s f t 3 v <br />