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INSTRUCTIONS FOR COMPLETING THE APPLICATION �.
<br /> This application form is for a Solid Waste Facilities Permit to receive,store,process,or dispose of solid wastes regulated by the Calif omia Waste Management ,
<br /> Board(Board).This form and the filing fee should be sent to the appropriate city or county Local Enforcement Agency(LEA).The exact amount of the filing tee
<br /> determined by the LEA. IT M
<br /> Complete this form and return it with a photocopy and two copies of the appropriate attachments determined to be necessary by your LEA All material should be
<br /> submitted on 8'/z"x 11"paper. Maps and other oversize documents should be folded to that size.
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<br /> The effective date of the application is the date when all required information and the correct fee are received by the LEA.The LEA will notify you of this effective
<br /> date. _ ;ft'.ti r
<br /> If you have any questions on the completion of this form, please contact the LEA or Board staff for assistance at(916)322.3330
<br /> No instructions will be listed for items that are self-explanatory. a°
<br /> I. GENERAL DESCRIPTION OF FACILITY
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<br /> TYPE OF WASTES TO BE RECEIVED: ...; ,,. ...�,.:
<br /> agricultural—wastes resulting from the production and processing of farm or agricultural products,including animal manures,prunings,and crop residues.
<br /> asbestos—a naturally occurring family of carcinogenic fibrous mineral substance.The State Department of Health Services has classified friable wastes which
<br /> contain more than one percent asbestos by weight as hazardous wastes.Friable means that the material can be crumbled with pressure and,therefore,is likely to
<br /> 'emit`fibers.
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<br /> ash—the residue from the incineration of solid wastes,including municipal waste.-infectious waste,woodwaste,sludge, and agricultural wastes.
<br /> auto shredder—the "fluff' consisting of upholstry, paint, plastics, and other non-metallic substances which remains after the shredding of automobiles,
<br /> discarded household major appliances, and sheetmetal.The State Department of Health Servicgs has classified untreated shredder wastes as hazardous.
<br /> construction/demolition wastes -- waste building materials, packaging and rubble resulting from construction, remodeling ,repair andademolition
<br /> operations, and consisting mainly of inert materials.
<br /> dead animals—animal carcasses requiring disposal that have not been previously0* for,medical purposes or with known infectious4seases
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<br /> industrial—solid or semi-solid wastes resulting from industrial processes and mandifacturj j epera, s,e.g.,cement kiln dust,ore process residues grit or
<br /> screenings removed from a waste water treatment facility, etc. r
<br /> infectious,wastes—wastes which have disease transmission potential are classified as`hazardous wastes-by the State Department of Health Services.
<br /> Infectious wastes include:pathological and surgical wastes,medical clinic wastes,wastes from biological laboratories,syringes,needles,_blades,tubing,bags
<br /> bottles, drugs, patient care items such as linen or personal or food service items from contaminated areas, chemicals,persona hygiene wastes, and animal
<br /> carcasses used for medical purposes or with known infectious diseases.
<br /> liquids—wastes which are not spadeable,usually containing less than 50 percent solids.These wastes include cannery and food processing wastes,landfill. .
<br /> leachate and gas condensate,boiler blowdown water,grease trap pumpings,oil and geothermal field wastes,septic tank pumpings,rendering plant byproducts,
<br /> some sewage sludge, etc. may be hazardous. r
<br /> mixed municipal—residential and commercial refuse,garbage and/or rubbish.Residential waste is commonly thought of as household,garbage;`nomnfercial
<br /> waste contains less putrecible waste and more paper and cardboard.
<br /> sewage sludge—human(not industrial)residue,excluding grit or screenings,removed from a waste water treatment facility or septic tank whether in a dry or
<br /> semidry form. `i
<br /> tires—discarded tire casings. Irl 4,
<br /> wood mill—shavings,sawdust,sanderdust,chips,bark,slabs,deck scrapings,edgings,wood and other flammable waste material incidental to theprocessing
<br /> of wood products.
<br /> II. FACILITY INFORMATION . r r
<br /> PROPOSED CHANGE IN DESIGN OR OPERATION. OR NO CHANGE; EFFECTIVE HATE: : .
<br /> For existing permitted facilities,when the operator proposes changes in design,operation,operator,or owner,details of the changes must be sent to the LEA.If
<br /> significant,the permit must be revised prior to implementation of the change. For an application for permit review, if there are no changes so indicate
<br /> AVERAGE ANNUAL LOADING (TPY): �
<br /> The average amount of wastes the facility will receive on a yearly basis over the next five years, expressed in tons. Must be consistent with the,RFI and any
<br /> California Environmental Quality Act(CEQA)requirements'Vol'ume figures should be converted to tons-and the'conversion factor should be documented in the
<br /> accompanying Report of Facility Information.
<br /> PEAK DAILY LOADING(TPD): pt w
<br /> The maximum amount of waste the facility is designed to receive, store, process, or dispose of per day,expressed in tons
<br /> FACILITY SIZE:
<br /> The area of the facility in acres to be used for receiving,storing,processing,or disposing of wastes,including all monitoring locations and any buffer tone This will
<br /> be referred to as the "permitted acreage" and is considered the facility boundaries. JLC �,y tsf" f g rF
<br /> III. OPERATOR INFORMATION �r '� a'r `
<br /> For land disposal operations,if operator is different from land owner,attach lease or franchise agreement documenting operator's interest in the real property,
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