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San Joaquin Valley Air Pollution Control District <br /> www valleyair org <br /> Permit Application For: <br /> ,lel. AUTHORITY TO CONSTRUCT (ATC) -New Emission Unit <br /> ( ] AUTHORITY TO CONSTRUCT (ATC) - Modification Of Emission Unit With Valid PTO/Valld ATC <br /> ( ] AUTHORITY TO CONSTRUCT (ATC) - Renewal of Valid Authority to Construct <br /> [ PERMIT TO OPERATE TO - 1316sti4g Emission Unit No,",R uirin a Permit to O rate <br /> 1 PERMIT TO BE ISSUED TO <br /> 2 MAILING ADDRESS <br /> sTItEETlP 0 eOx 3 0�T + are �'d s -e +o O <br /> -DIGIT <br /> CITY PSTATE 9 7b Cor-iSZIP CODE Sb __6[ 41 p [ ( ` <br /> 3 LOCATION WHERE THE EQUIPMENT WILL BE OPERATED WM-E N 1,000 Fr OF A <br /> sum 2_3S-C'( S, Sav,f q Fe R d CITY R k V'e r5a A 1"*' SCHOOL? [ ] YES XNO <br /> 1<`�Z SV ba SECTION 2 TOWNSHIP 3 So U*t\ RANGE 9 Ea 5 t S I C CODE(S)OF FACILITY <br /> lam ) <br /> 4 GENERAL NATURE OF BUSINESS i t_ M� �.� INSTALL DATE July ?-002- <br /> 5 <br /> OOZ5 TITLE V PERMIT HOLDERS Do you request a COC (EPA Review) prior to receiving your ATC? [ ]YES [ ]NO <br /> ONLY <br /> 6 DESCRIPTION OF EQUIPMENT OR MODIFICATION FOR WHICH APPLICATION IS MADE(include Perndt# , and use <br /> additional sheets if necessary) <br /> so V-af)or e)C -raC+.On 9'\/S+evq '1-0 M(*\ove kyjr0 CarbbRj -�raln StlbStrr �aG <br /> +;`"lr-sfi 3—� tnonthS', dest�r-oy Ati(dre,cwr(oons with Cai-a1y$i� oXid�?2-C, <br /> Re^ove— co,+akY+ie_ oK14% zer- ¢ 1'emeA�a4-e Self vapor vlQ <br /> c.arlson weSselS <br /> 7HAVE YOU EVER APPLIED FOR AN ATC OR [ ] YES jllal>d NO OptioSection <br /> PTO IN THE PAST? 10 CHECK WHETHER YOU ARE A SPA <br /> If yes,ATC/PTO# PARTICIPANT IN EITHER OF <br /> 8 IS THIS PROPERTY ZONED PROPERLY FOR THESE VOLUNTARY PRgGRAnsS7THE PROPOSED USE? RYES 1 ] NO "SPARE THE ATR" <br /> 9 IS THIS APPLICATION SUBMITTED AS THE <br /> RESULT OF EITHER A NOTICE OF [ ]YES NO [ ]Yes ["INSPECT,Send info t���� <br /> VIOLATION OR A NOTICE TO COMPLY? If yes, NOVINTC# [ ]Yes [ ]No [ ]Send info <br /> 11 TYPE OR PRINT NAME OF APPLICANT TITLE OF APPLICANT <br /> RC IO n Care S1acoR stat --f� rseola �5fi' <br /> 12 SIGNATURE OF APPLICANT DATE PHONE# 16 86 — o ifW X <br /> p.Z FAx # (Iq 6� 61-� <br /> 6101430 <br /> 1 E-MAII. p C_ca r e C_C vA <br /> FOR APCD USE ONLY <br /> DATE STAMP FILING FEE <br /> RECEIVED $ CHECK# <br /> DATE PAID <br /> PROJECT# FACILITY ID <br /> Northern Regional Office *4Z30 Kiernan Avenue,Suite 130*Modesto, California 95356-9321 * (209) 557-6400*FAX (209) 557-6475 <br /> Central Regional Office * 1990 East Getlyshurg Avenue '*Fresno,California 93726-0244 * (559) 230-5900 *FAX(559) 230-6061 <br /> Southern Regional Office*2700 M Street,Suite 275 *Bakersfield, California 93301-2370#(661)326-6900 *FAX(661) 326-6985 <br /> xev Aymao <br />