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Part 5. COMPLIANCE WITH CALIFORNIA ENVIRONMENTAL QUALITY ACT (CEQA)(Check applicable boxes) <br />A. CHECK BOX(ES) IF ENVIRONMENTAL DOCUMENT WAS OR WILL BE PREPARED FOR THIS PROJECT AND PROVIDE THE STATE CLEARINGHOUSE NUMBER (SCH#): <br />® ENVIRONMENTAL IMPACT REPORT (EIR)SCH# 9209072 2/94 <br />NEGATIVE DECLARATION (NDyMITIGATED NEGATIVE DECLARATION (MND) SCH# <br />QADDENDUM TO (Identify environmental document) SCH# <br />B. IF ENVIRONMENTAL DOCUMENT(S) WAS NOT PREPARED, PLEASE PROVIDE THE FOLLOWING INFORMATION: <br />[_]CATEGORICAUSTATUTORY EXEMPTION (CE/SE) <br />EXEMPTION TYPE GUIDELINE # <br />Part 6. LIST OF ATTACHMENTS (Fill in the date for each document checked) <br />A. REQUIRED WITH ALL APPLICATION SUBMITTALS: <br />®RFI/JTD TPR -Dated 01-2005 FA#0001434 Amendments 3/05 ®ENVIRONMENTALDOCUMENT(S): <br />®LOCALUSE/PLANNING PERMITS UP -93-2 10/93 YJEIR SCH 49209072 2/94 <br />®LOCATION MAP ❑ MND/ND <br />®MITIGATION MONITORING IMPLEMENTATION SCHEDULE 7/6/93 ❑ EXEMPTION <br />❑ ADDENDUM <br />B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br />OPERATING LIABILITY FINANCIAL MECHANISM ❑FINANCIAL RESPONSIBILITY DOCUMENTATION <br />MCLOSURE/POST CLOSURE MAINTENANCE PLAN ❑LANDFILL CAPACITY SURVEY RESULTS (see instructions) <br />❑ PRELIMINARY _ ..._. <br />❑ FINAL <br />C. IF APPLICABLE: <br />' DREPORT OF WASTE DISCHARGE []DEPT. OF HEALTH SERVICES PERMIT <br />"`❑CONTRACT AGREEMENTS " "' ❑ SWAT (Air and water) <br />�STORMWATER PERMIT APPLICATION ` WETLANDS PERMITS <br />ONPDES PERMIT APPLICATION- - VERIFICATION OF FIRE DISTRICT COMPLIANCE r <br />❑OTHER <br />Part 7. OWNER INFORMATION (For disposal site, if operator is different from landowner, attach lease or other agreement) <br />TYPE OF BUSINESS: <br />�SOLE PROPRIETORSHIP ®PARTNERSHIP❑CORPORATION �GOVERNMENTAGENCY <br />OWNER(S) OF LAND SSN OR TAX ID # <br />(Name): San Joaquin County <br />Department of Public Works -Solid Waste Division 6800-14563 <br />ADDRESS, CITY, STATE, ZIP TELEPHONE #: <br />PO Box 1810 (209) 468-3066 <br />Stockton, CA 95201 FAX#: - <br />(209) 468-3078 <br />DReno@sjgov.org <br />Desi Reno <br />Page 3 <br />