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11 <br /> IR -'STATE OF CALIFORNIA <br /> CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD :;: <br /> REGIONAL WATER QUALITY CONTROL BOARD . <br /> APPLICATION FOR SOLID WASTE FACILITY PERMITIWASTE DISCHARGE REQUIREMENTS <br /> CIWMB E-1-77(Rev. <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 /> �.-k. <br /> FOR OFFICIAL USE ONLY f " <br /> SWIS 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 /> Count of San Joaquin, Environmental Health Department San Joaquin <br /> C.TYPE: A LI ATI N( heck one box only): <br /> 1. NEW SWFP and/or WDRS R4.PERMIT REVIEW <br /> X❑2. REVISION OF SWFP and/or WDRS ®5.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 /> 30703 S. Macarthur Drive,Tracy,CA 95376 <br /> 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 /> X❑5.OTHER(describe): Cannery Waste <br /> 01.DISPOSAL E13.TRANSFORMATION <br /> a. TYPE: <br /> X❑2.COMPOSTING [3C14.TRANSFER/PROCESSING 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 /> X❑1.FACILITY IS IDENTIFIED IN(Check one): <br /> El SITING ELEMENT DATE OF DOCUMENT Mar-97 PAGE# <br /> NONDISPOSAL 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 /> -11.AGRICULTURAL X�6.CONSTRUCTION/DEMOLITION M11.LIQUIDS <br /> F-12.ASBESTOS ❑Friable ❑Non-friable F--17,CONTAMINATED SOILS X❑12.MIXED/MUNICIPAL SOLID WASTE <br /> E-13.ASH E-18.DEAD ANIMALS ®13.SEWAGE SLUDGE <br /> ❑4.AUTO SHREDDERX�9.INDUSTRIAL X❑14.TIRES <br /> X❑10.INERTX❑15.OTHER(describe): Appliances, u-waste,a-waste <br /> XI5.COMPOSTABLE MATERIAL(describe): Green Waste, Food Waste <br /> Page 1 <br />