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San Joaquin Valley Air Pollution Control District <br /> www.valleyair.org <br /> Permit Application For: <br /> [X] AUTHORITY TO CONSTRUCT(ATC) -New Emission Unit <br /> [ ] AUTHORITY TO CONSTRUCT(ATC) -Modification Of Emission Unit With Valid PTO/Valid ATC <br /> [ ] AUTHORITY TO CONSTRUCT(ATC) -Renewal of Valid Authority to Construct <br /> [ ] PERMIT TO OPERATE(PTO) -Existing Emission Unit Now Requiring a Permit to Operate <br /> 1. PERMIT TO BE ISSUED TO:Ameresco Forward,LLC <br /> 2. MAILING ADDRESS: <br /> STREET/P.O.BOX: 111 Speen Street, Suite 410 <br /> 9-DIGIT <br /> CITY: Frammg'bam STATE: MA ZIP CODE: 01701 <br /> 3. LOCATION WHERE THE EQUIPMENT WILL BE OPERATED: WITHIN 1,000 FT OF A <br /> STREET: 9999 South Austin Rd. CITY: Manteca SCHOOL? [ ]YES [X]NO <br /> S.I.C.CODE(S)OF FACILITY <br /> A SECTION 2 TOWNSHIP I South RANGE 7 East (If known):4953 <br /> 4. GENERAL NATURE OF BUSINESS:Landfill gas to energy facility INSTALL DATE:ASAP <br /> 5. TITLE V PERMIT HOLDERS ONLY: Do you request a COC(EPA Review)prior to receiving your ATC(Ifyes, [ ]YES [ ]NO <br /> please complete and attach a Compliance Certification form(TVFORM-009)? <br /> 6. DESCRIPTION OF EQUIPMENT OR MODIFICATION FOR WHICH APPLICATION IS MADE(include Permit#'s if known,and use additional <br /> sheets if necessary) <br /> Jenbacher JGS 616(18 Bar)internal combustion engine. <br /> 7. PERMIT REVIEW PERIOD: Do you request a three-or ten-day period to review the draft Authority to Construct [ ]3-day review <br /> permit?Please note that checking"YES"will delay issuance of your final permit by a corresponding number of [X] 10-day review <br /> working days. See instructions for more information on this review process. No review requested <br /> 8. HAVE YOU EVER APPLIED FOR AN ATC OR PTO IN [ ]YES [X]NO Optional Section <br /> THE PAST? If yes,ATC/PTO#: 11.DO YOU WANT TO RECEIVE INFORMATION <br /> ABOUT EITHER OF THE FOLLOWING <br /> 9. IS THIS APPLICATION FOR THE CONSTRUCTION OFA [X]YES ]NO VOLUNTARY PROGRAMS? , <br /> NEW FACILITY? [ H 0 TL 1 7 <br /> (If"Yes"is checked,please complete the CEQA Information form) [ ]"HEALTHY AIR LIVING <br /> [ ]YES [X]NO (HAL)BUSINESS PARTNER" LIVINGAIR <br /> 10.IS THIS APPLICATION SUBMITTED AS THE RESULT <br /> OF EITHER A NOTICE OF VIOLATION OR A NOTICE TO If yes,NOV/NTC#: 1 <br /> COMPLY? [ ]"INSPECT" 0"1" <br /> 12. TYPE OR PRINT NAME OF APPLICANT: Joseph P. DeManche TITLE OF APPLICANT:Executive Vice <br /> President <br /> 13. SIGNATURE OF APPLICANT: DATE: PHONE#: ( 508 )661-2266 <br /> FAX #: ( ) <br /> E-MAIL:jdemanche@ameresco.com <br /> FOR APCD USE ONLY: <br /> DATE STAMP: FILING FEE <br /> RECEIVED: $ CHECK#: <br /> DATE PAID: <br /> PROJECT#: FACILITY ID: <br /> Northern Regional Office*4800 Enterprise Way*Modesto,California 95356-8718*(209)557-6400*FAX(209)557-6475 <br /> Central Regional Office* 1990 East Gettysburg Avenue*Fresno,California 93726-0244*(559)230-5900*FAX(559)230-6061 <br /> Southern Regional Office*34946 Flyover Court*Bakersfield,California 93308*(661)392-5500*FAX(661)392-5585 <br /> Rev:April 2010 <br />