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STATE OF CALIFORNIA <br /> CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> REGIONAL WATER QUALITY CONTROL BOARD <br /> APPLICATION FOR SOLID WASTE FACILITY PERMITIWASTE DISCHARGE REOUIREMENTS <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: FILING FEE: RECEIPT NUMBER: DATE RECEIVED: <br /> DATE ACCEPTED: DATE REJECTED: ACCEPTANCE DATE OF <br /> INCOMPLETE <br /> APPLICATION: <br /> DATE DUE: <br /> Part 1.GENERAL INFORMATION <br /> A.ENFORCEMENT AGENCY: B.COUNTY: <br /> Counof San Joaquin, Environmental Health Department San Joaquin <br /> C.TYPE A PLI A I N(check one box only): <br /> 1. NEW SWFP and/or WDRS 04.PERMIT REVIEW <br /> XX 2. REVISION OF SWFP and/or WDRS 05.AMENDMENT OF APPLICATION <br /> 113. EXEMPTION and/or WAIVER 116.RFI/ROWD/JTD AMENDMENTS <br /> Part 2. FACILITY DESCRIPTION <br /> A. NAME OF FACILITY: <br /> Tracy Material Recovery&Transfer Station <br /> B. LOCATION OF FACILITY: <br /> 1. PHYSICAL ADDRESS OR LOCATION AND ZIP CODE: <br /> AIM 30703 S. Macarthur Drive,Tracy,CA 95376 <br /> qw 2. LATITUDE AND LONGITUDE: <br /> Lat 37.67803 North, Long-121.41618 West <br /> 3. LEGAL DESCRIPTION OF PERMITTED BOUNDARY BY SECTION,TOWNSHIP,RANGE,BASE,AND MERIDIAN,IF SURVEYED: <br /> n/a <br /> C.TYPE OF ACTIVITY:(Check applicable boxes): <br /> �1.DISPOSAL F-13.TRANSFORMATION -15.OTHER(describe): Cannery Waste <br /> a. TYPE: <br /> M2.COMPOSTING X❑4.TRANSFERIPROCESSING FACILITY <br /> Green Waste/ X CHECK HERE IF RECYCLABLE MATERIALS ARE RECOVERED PRIOR TO TRANSFER/PROCESSING. <br /> a. TYPE: Food Waste <br /> D.CONFORMANCE FINDING INFORMATION(CIWMP): <br /> ®1.FACILITY IS IDENTIFIED IN(Check one): <br /> X❑SITING ELEMENT DATE OF DOCUMENT Mar-97 PAGE# <br /> ONONDISPOSAL FACILITY EL DATE OF DOCUMENT PAGE# <br /> R2.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 /> X❑1.AGRICULTURAL -16.CONSTRUCTION/DEMOLITION ❑11.LIQUIDS <br /> 02.ASBESTOS ❑Friable El Non-friable ®7.CONTAMINATED SOILS X❑12.MIXED/MUNICIPAL SOLID WASTE <br /> M3.ASH F-18.DEAD ANIMALS ❑13.SEWAGE SLUDGE <br /> 4V4.AUTO SHREDDERX�9.INDUSTRIAL rX-114.TIRES <br /> a15.OTHER(describe): Appliances, U-waste,a-waste <br /> Fx <br /> D10.INERT <br /> X❑5.COMPOSTABLE MATERIAL(describe): Green Waste, Food Waste <br /> Page 1 <br />