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STATE OF CALIFORNIA CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> SOLID WASTE FACILITIES PERMIT APPLICATION <br /> CtWMB E-1.77 6tEV.6/921 <br /> ENFORCEMENT AGENCY: FOR ENFORCEMENT AGENCY USE ONLY <br /> San Joaquin Public Health Services 304 E. Weber FILE NUMBER(PERMIT NUMBER) DATE RECEIVED: <br /> DATE ACCEPTED: <br /> OCOUNTY: DATE REJECTED: <br /> S FILING FEE: <br /> TYPE OF APPLICATION: RECEIPT NUMBER <br /> CO SWMP/COUNTYWIDE <br /> ®1. NEW SOLID WASTE FACILITY PERMIT ®4.MODIFICATION OF PERMIT ®7.AMENDMENT OF APPLICATION iWMP REFERENCE PAGEIS): <br /> ®2. REVISION OF PERMIT ®5. EXEMPTION FROM PERMIT <br /> ®3. PERMIT REVIEW ®6. FACILITY CLOSURE <br /> NOTE:This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the <br /> local enforcement agency. See instructions for completing this application. <br /> L GENERAL NAME OF FACILITY: Grover Environmental Como U • <br /> DESCRIPTION LOCATION OF FACILITY: (Give address or location•also include legal description by section,township,range,base,and <br /> OF meridian If surveyed or projected. <br /> FACILITY <br /> TYPE OF FACILITY: ®LANDFILL ®PROCESSING FACILITY ®MATERIAL RECOVERY FACILITY <br /> ❑SUMP ®TRANSFER STATION ®LAND SPREADING <br /> ®TRANSFORMATION ®COMPOSTING (clean green) <br /> FACILITY (MIXED WASTES) <br /> TYPE OF WASTES TO BE RECEIVED: <br /> ®AGRICULTURAL ®DEAD ANIMALS ®TIRES <br /> ®ASBESTOS ®INDUSTRIAL ®WOOD MILL <br /> ®ASH ®LIQUIDS (INCLUDES SEPTAGE) ®OTHER DESIGNATED WASTE <br /> ®AUTO SHREDDER ®MIXED MUNICIPAL (clean gr)eWOOTHER HAZARDOUS WASTE <br /> ®CONSTRUCTION/DEMOLITION ®SLUDGE ®OTHER: (DESCRtBE) <br /> It.FACILITY PROPOSED CHANGE EFFECTIVE DATE <br /> INFORMATION ®COMMENCED (CHECK APPLICABLE BOXES( OF PROPOSED CHANGE: <br /> Date: ®DESIGN <br /> ®WILL COMMENCE ®NO CHANGE <br /> Date: <br /> ®OPERATION <br /> AVERAGE ANNUAL PEAK DAILY FACILITY ISITE CAPACITY EXPECTED CLOSURE DATE: <br /> LOADINGOW): LOADINGCIPD): 500 SIZE(A): 34 acres IN YARDS: 100NQUE <br /> III.OPERATOR OWNER OF LAND ADDRESS: TELEPHONE NUMBER. <br /> INFORMATION Warne): )•ecJels <br /> For land dispe", Sugar (;0 nc. 18500 Spreckels Road Manteca CA 95336 (209) 823-3121 <br /> If operator Is FACIUTY OPERATOR ADDRESS: <br /> dI farent from 1IName): Grover <br /> land owner,attach Lffidmaw- Senj=, Inc- 12M Uff= Blvd, Maateca, CA 25136 — (2M) 504MI <br /> lease or franchise ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: TELEPHONE NUMBER: <br /> agreamartt. 12825 Kiernan Avenue Modesto, CA 95356 1 (209). 545-Ml <br /> 1 hereby acknowledge that I have read this application and the Report of Facility Information, and certify that the information given is <br /> true and accurate to the best of my knowledge and belief. In operating the solid waste facility,.)agree to comply with the conditions <br /> of the permit and with federal, state, end local enactments. <br /> SIGNATURE ILAN bW O NT): SIGNATURE (FACILITY OPERAT R O G <br /> 4L <br /> 41 4 <br /> TYPED NAME: Ed Pa olini TYPED NAME: Mark S. Grover <br /> TITLE: District M r DATE: TITLE` President �y 3 r5 <br /> Y.LIST OF ATTACHMENTS (CHECK IF APPLICABLE): <br /> REPORT OF FACILITY INFORMATION ®SWAT(AIR AND WATER) <br /> ®PERIODIC SITE REVIEW QSTORMWATER DISCHARGE PERMITS(NPOES) <br /> ®LOCAL USE PERMITS ®WETLANDS PERMIT <br /> ®OPERATING LIABILITY FINANCIAL MECHANISM ®PRELIMINARY CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br /> ®DEPARTMENT OF HEALTH SERVICES PERMIT aFINAL CLOSURE/POSTCLOSURE MAINENANCE PLAN <br /> ®AIR QUALITY/POLLUTION CONTROL DISTRICT PERMITS ®FINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ®CERTIFIED ENVIRONMENTAL REVIEW REPORTS ICEGA) ®OTHER REGULATORY AGENCY PERMITS <br /> ®WASTE DISCHARGE REQUIREMENTS ®OTHER <br /> LS6/621 <br />