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STATE F CALIFORNIA <br />CALIFORN-� INTEGRATED WASTE MANAGEMENT BOARD <br />i P0 40 <br />,,,C:4ONAL WATER QUALITY CONTROL BOARD <br />APPLICATION FOR SOLID WASTE FACILITY PERMITIWASTE DISCHARGE REQUIREMENTS <br />CIWMB E-1,-77 (Rev. 8-04) <br />NOTE: This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the appropriate agency. <br />Please refer to the attached instructions for definitions of terms and for completing this application form in a complete and correct manner. <br />FOR OFFICIAL USE ONLY <br />WIS NUMBER: <br />FILING FEE: <br />RECEIPT NUMBER: <br />DATE RECEIVED: <br />39 -AA -0022 <br />DATE ACCEPTED: <br />DATE REJECTED: <br />ACCEPTANCE DATE OF <br />INCOMPLETE <br />APPLICATION: <br />.j2_ 6110 <br />DATE DUE: <br />Part 1. GENERAL INFORMATION <br />A. ENFORCEMENT AGENCY: B. COUNTY: <br />Environmental Health Department San Joaquin Count <br />C. TYPE OF APPLICATION (Check one box only): <br />1. NEW SWFP and/or WDRS 04. PERMIT REVIEW <br />®2. REVISION OF SWFP and/or WDRS �5. AMENDMENT OF APPLICATION <br />11 3. EXEMPTION and/or WAIVER ®6. RFI/ROWD/JTD AMENDMENTS <br />Part 2. FACILITY DESCRIPTION <br />A. NAME OF FACILITY: <br />North County Recycling Center and Sanitary Landfill <br />B. LOCATION OF FACILITY: <br />1. PHYSICAL ADDRESS OR LOCATION AND ZIP CODE: <br />17720 East Harney Lane, Lodi, CA 94240 (nearest cross street = Atkins Road) <br />2. LATITUDE AND LONGITUDE: <br />Latitude 38 deg 06 min , Longitude 121 deg 04 min <br />3. LEGAL DESCRIPTION OF PERMITTED BOUNDARY BY SECTION, TOWNSHIP, RANGE, BASE, AND MERIDIAN, IF SURVEYED: <br />APN 065-120-02, 065-120-03, 065-120-08, and 065-120-09 in Section 21 T3N, R8E, MDB&M <br />C. TYPE OF ACTIVITY: (Check applicable boxes): <br />®1. DISPOSAL 03. TRANSFORMATION ®5. OTHER (describe): <br />a. TYPE: <br />F-12. COMPOSTING <br />a. TYPE: <br />Class III <br />®4. TRANSFER/PROCESSING FACILITY (Processing) <br />Recovery of recyclable materials prior to disposal <br />Processing green wase prior to removal <br />X CHECK HERE IF RECYCLABLE MATERIALS ARE RECOVERED PRIOR TO TRANSFER/PROCESSING. <br />D. CONFORMANCE FINDING INFORMATION (CIWMP): <br />®1. FACILITY IS IDENTIFIED IN (Check one): <br />®SITING ELEMENT <br />®NONDISPOSAL FACILITY EL <br />DATE OF DOCUMENT April 1996 <br />DATE OF DOCUMENT <br />F12. FACILITY IS NOT REQUIRED TO BE IDENTIFIED IN SITING ELEMENT OR NONDISPOSAL FACILITY ELEMENT <br />E. TYPE OF PERMITTED WASTES TO BE RECEIVED: (Check applicable boxes): <br />®1. AGRICULTURAL <br />E-12. ASBESTOS o Friable o Non -friable <br />E-13. ASH <br />®6. CONSTRUCTION/DEMOLITION <br />E-17. CONTAMINATED SOILS <br />®8. DEAD ANIMALS <br />F-111. LIQUIDS <br />®12. MIXED/MUNICIPAL SOLID WASTE <br />M 13. SEWAGE SLUDGE <br />PAGE # 18 <br />PAGE # <br />❑4. AUTO SHREDDER ®9. INDUSTRIAL ®14. TIRES <br />®10. INERT ®15. OTHER (describe): HHW, paint, wood waste (including treated wood waste), <br />and yard clippings and other items as described in JTD. <br />®5. COMPOSTABLE MATERIAL (describe): Green waste and discarded lumber processed prior to remova <br />