Laserfiche WebLink
Pati 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 />[X] ENVIRONMENTAL IMPACT REPORT (EIR) SCH# 9209072 2/94 <br />aNEGATIVE DECLARATION (ND)/MITIGATED NEGATIVE DECLARATION (MND) SCH# <br />OADDENDUM TO (Identity environmental documenq <br />SCH# <br />B. IF ENVIRONMENTAL DOCUMENT(S) WAS NOT PREPARED, PLEASE PROVIDE THE FOLLOWING INFORMATION: <br />r--JCATEGORICAUSTATUTORY EXEMPTION (CE/SE) GUIDELINE # <br />EXEMPTION TYPE <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 ®EEIRENVIRONMENTAL <br />OCUME 072 2/94 <br />®LOCALUSE/PLANNING PERMITS UP -93-2 10/93 <br />❑ MND/ND <br />®LOCATION MAP <br />7/6/93 ❑EXEMPTION <br />®MITIGATION MONITORING IMPLEMENTATION SCHEDULE <br />❑ ADDENDUM <br />B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br />QOPERATING LIABILITY FINANCIAL MECHANISM <br />[:]CLOSURE/POST CLOSURE MAINTENANCE PLAN <br />❑ PRELIMINARY" <br />❑ FINAL <br />C. IF APPI,ICPIBLE: <br />'nREPORTOF WASTEDI$CHARGE <br />-QCONTRACT'AGREEMENTS <br />E]$TORMWATER PERMIT APPOCATIDN - <br />ONPDES PERMIT APPLICATION --- <br />00THER <br />Part 7. OWNER INFORMATION` (For disposal site, if operator is different from land owner, attach lease or other agreement) <br />TYPE OF BUSINESS: CORPORATION <br />®SOLE PROPRIETORSHIP E] PARTNERSHIP <br />OWNER(S) OF LAND <br />(Name): San Joaquin County <br />Department of Public Works—Solid Waste Division <br />ADDRESS, CITY, STATE, ZIP <br />PO Box 1810 <br />Stockton, CA 95201 <br />�GOVERNMENTAGENCY <br />SSN OR TAX to # <br />6800-14563 <br />TELEPHONE #: <br />(209) 468-3066 <br />FAX #: <br />(209) 468-3078 <br />E-MAIL ADDRESS: <br />DReno@sjgov.org <br />CONTACT PERSON (Print Name): <br />Desi Reno <br />Page 3 <br />