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BASE <br />-r•••• • 4 <br />EXPLANATION <br />• <br />1W1 E i.:t , t !kW r. 7 A kj kili 'It t <br />I hereby certify that I have-.prepared this <br />ordinances, state law , and iules and r <br />APPLICANT'S SIC.NA'UF1E X <br />plic0.9n and that the work will be done in accordance with San Joaquin County <br />lion the San Joaquin Local Health District <br />FOR DEPARTMENT USE ONLY <br />Fee Is Due: 0 ANNUALLY 0 PER UNIT 0 PER S,TE 0 EALF, 0 Jan.id,y Fle,..tveG Es, Jdf <br />BILLING REMITTANCE S <br />DATE DATE REMITTED <br />FEE <br />LESS <br />PRORATION <br />PLUS PENALTY <br />Lit HEN <br />; i I <br />, <br />1 6 Fi.n.e.rea B, • <br />REM. T <br />DUE CHECNE:: <br />AMOUNT <br />Applications Will be Processed When Submitted Properly Completed. Be Sure To Sign The Application. <br />APPLICATION <br />(For Non-Transferable. Revocable, and Suspendable) <br />ENVIRONMENTAL HEALTH PERMIT <br />LIQU!D WASTE <br />Application is hereby made to carry on business in the jurisdictional area of the San Joaquin Local Helitri District <br />Business Name IDBA) Valley Mechanical, Inc. Address P.O.Box 5126, Stockton, CA <br />a Owner George Fleck Address P.G.Boy. 5126, Stockton, CA 95205 <br />(±,) Firm Partners, Addresses and Telephone Numbers <br />7ri Business Telephone No .209-931-4031 Emergency Telephone No 209-462-2905 <br />.1 Contractor Licence No. _ _ <br />Applicants Name (Print) JiM Title Estimator Date 3/8/83 <br />Pleas* check Applicable Category (1-7) and Fill in the Required Inlormation <br />0 PUMPER VEHICLE PERMIT REGISTRATION (FOR EACH VEHICLE) <br />For July 1, _ June 30, 19 Disposal Sites <br />Description (Make/Yr., Color) <br />Serial No. CAL. License No. CAL. License Reiiewal No. <br />Capacity . _ _ Gal., Weights S Measures No. <br />Equipment Parking Address <br />C PUMPER YARD <br />For July 1, . _ June 30, 19 <br />No. of Vehicles Stored <br />No of Chemical Toilets Stored _ <br />0 PERCOLATION TEST <br />R.S. or R.C.E. Name P.S. or R.C.E. No. <br />Test Location Test Date/Time <br />El SANITATION PERMIT e 2 • <br />Job Address/Location _46_4_4. A Writ er too. h.Lockton.,,, CA 95205 <br />Owner Marlowe Properties Address P4.Bok.21.1, San__Rafael,CA 94915 <br />0 SEPTIC TANK 0 CESSPOOL 02 LEACHING FIELD 0 SLIPAGE PIT 0 PACKAGE PLANT <br />0 PERMANENT 0 TEMPORARY 0 NEW El REPAIR 0 OTHER <br />0 CHEMICAL TOILETS For July 1, - June 30. 19 <br />Type Construction Disposal Site <br />No. of Units . _ _ Equipment Storage/Cleaning Location(s) <br />0 PACKAGE TREATMENT PLANT For July 1, - June 30. 19 <br />Operator Name Where Certified <br />Plan! Location <br />Plant Capacity No Units Served <br />0 LAUNDRY For July 1,- June 30, 19 . <br />SIZE 0 Less Than 1,000 Sq. Ft_ 0 More Than 1,000 Sq Ft <br />o DRY CLEANINC Chemi:als Used/Amount/Mo..........-_- <br /> <br />n',10 CoWntl,orfIce...tdsgent'i I •••••i ••••• •,•••• • 1,..c • , •- • 17 II I -• : ',I/N.4 I 7,•• ' r !: 7 .h. C.- -tr s in sieb ist.MraVenc, en-rrtiT,X.• I c' <br /> <br />„.tD WO, r 01Ca.•101111.1. <br />.'Iii' • plc./ ar • <br />J>,