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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 /> FIENVIRONMENTAL IMPACT REPORT(EIR)SCH# SCH#93042093 <br /> 0 FE NEGATIVE DECLARATION(ND)/MITIGATED NEGATIVE DECLARATION(MND)SCH# SCH#2011102013 <br /> ADDENDUM TO(Identify environmental document) SCH# <br /> B. IF ENVIRONMENTAL DOCUMENT(S)WAS NOT PREPARED,PLEASE PROVIDE THE FOLLOWING INFORMATION: <br /> F-1CATEGORICAUSTATUTORY 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 /> x]RFI/JTD February 2013 xQENVIRONMENTAL DOCUMENT(S): <br /> XPLOCAL USE/PLANNING PERMITS UP-93-41, PA-0800005 X EIR SCH#93042093 <br /> XXLOCATION MAP February 2013 x SCH#2011102013 <br /> MITIGATION MONITORING IMPLEMENTATION SCHEDULE X Exemption NOE July 5, 2006 <br /> ❑ADDENDUM <br /> B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br /> ®OPERATING LIABILITY FINANCIAL MECHANISM_ n/a FINANCIAL RESPONSIBILITY DOCUMENTATION n/a <br /> ❑CLOSURE/POST CLOSURE MAINTENANCE PLAN n/a LANDFILL CAPACITY SURVEY RESULTS(see instructions) n/a <br /> ❑ PRELIMINARY <br /> ❑ FINAL <br /> C. IF APPLICABLE: <br /> X REPORT OF WASTE DISCHARGE Waiver,3194 ®DEPT.OF HEALTH SERVICES PERMIT <br /> CONTRACT AGREEMENTS SWAT(Air and water) <br /> STORMWATER PERMIT APPLICATION ®WETLANDS PERMITS <br /> ®NPDES PERMIT APPLICATION ❑VERIFICATION OF FIRE DISTRICT COMPLIANCE <br /> POTHER APCD Permit to Construct#N-3187-4-0 <br /> Part 7. OWNER INFORMATION (For disposal site,if operator is different from land owner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> OSOLE PROPRIETORSHIP PARTNERSHIP r17CORPORATION FIGOVERNMENTAGENCY <br /> OWNER(S)OF LAND SSN OR TAX ID# <br /> (Name): <br /> Mike Re etto #680293953 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE#: <br /> Tracy Material Recovery and Transfer Facility (209)835-0601 <br /> 30703 S. MacArthur Drive Tracy CA 95376 <br /> FAX#: <br /> (209)835-7729 <br /> E-MAIL ADDRESS: <br /> miker@tdswm.com <br /> CONTACT PERSON(Print Name): <br /> Mike Repetto <br /> Page 3 <br />