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Site Identification Form (SIP) <br /> (See LEA Advisory No. 3 -for Guidance) <br /> Y Date of Field Ytsit :' 9/13/2010 Frill up vesttation„(Y/1T} N <br /> Nadi Forward Landfill,Inc. <br /> Gotixit San Joaquin Nearesfi Towin/tCiFrench Camp <br /> Y' a 11 w F�,l1iu t <br /> Stte Address 9999 S.Austin Rd.,Manteca CA SWIS 39-AA-0015 <br /> Zi ,4 95336Pia: 20106003 <br /> J�atxlude De ee JC nute Second 4A,0730VUNMA,�1 <br /> Land Owner Information: <br /> Land Owner Name Forward Inc. <br /> Address 9999 S. Austin Rd. <br /> f <br /> City: Manteca State. CA Zip95336 <br /> Phone:. (209) 982-4298 1,Fax (209) 982-1009 <br /> g },, z <br /> Sl�c'S eCificX �,ii�n�: <br /> seasonalN/A <br /> N Dateo Clnsttt N/A ` <br /> . ” .,.. .. <br /> , <br /> Inspectiori�Frequexey„ 9/13/2010 <br /> annually Date `` <br /> iispectionc'Frunb��RclucttoRequestl] ` ' Y 1atclItequest 01/10/11 <br /> . . <br /> , . <br /> �T`rae�ing,Sysferr r � � Date of Apro��al�a*�' <br /> Site Type t3 Burn Durnpr I1egal hump Site x Other Yj Exempt site <br /> SteCateppcI M1 ] idgaDat , r� <br /> ;,Surrouridrt Lan Use © mescal : ',Iszdentialh',` a Industnal x11, <br /> otti a gr <br /> :...icultural <br /> Comments/Recommendations <br /> The site is only active during the cannery season(July-October). There is no reason to conduct an <br /> Inspection out side that date range because there is no site activity. <br /> LEA Staff Name Benjamin Escotto —F§ignourcjDate 11111111 <br /> CIWMB STAFF ONLY: <br /> Enter Iri T61 8W19"',By Date <br />