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01/27/201.0 1.8:13 FAX 230647* ® Q004/006 ' <br /> San Joaquin Valley Air Pollution Control District <br /> www.valleyair.org REc <br /> Rule 4570 Permit Application Dorm ' % 2 f <br /> Poultry Confined Animal Feeding(CAF)Mitigation Measures <br /> Facility Frame: o I i V ey-o, Gq c� R.3L n C 1-t LLC. <br /> Facility Location: 952- W' Q"J m a,' Rd j Pre ocC Ca v)tp C19 9 5'2-3) <br /> Mailing Address: P O 90,> Z Z l -2, ( 5ah :1-0Se- CA qs' I S Z <br /> Phone N'o.: �(( 0 `S) ZS$'_ $0 7 y Cell Phone No.: (y n$) 3 0 1 -19'0'9'3 <br /> Owner/Operator: Eo1 w cLr-a F. (�j!ye ra. Sr, Title: (�( _pay fn ie r <br /> Signature: 0 A Date: <br /> 1. Please completely fill out the tables included in the following pages of this form indicating <br /> the mitigation measures that you will be utilizing to comply with Rule 4570. <br /> 2. This application must be submided with application filing fees totaling$130($65 per <br /> permit unit x 2 permit units). If submitting this forth at a workshop please do not submit <br /> the fees at the workshop. The District will send you an invoice at a Iater date. <br /> 3. Have you received a CMP Plan as required by District Rule 4550 or permit from the <br /> District for your existing poultry operation? _ <br /> • If yes,what is your facility number? �/ 7 6 2 <br /> • If you have not received a CMP Plan or permit from the District, you must fill out the <br /> following application forms and attach them to this form. The application forms may <br /> be found on the District's website at tette://www.vatleyair orslGenerat Info/A()Loader him: <br /> • Initial Permit Application Form for Farms(Form"PA-0") <br /> • Poultry Farm Permit Application Form(Form"Poultry") <br /> • CMP Plan Application(Form"CMP 011) <br /> • CMP Poultry Supplemental Application(Form"CMP 15") <br /> • Other Applicable CMP Supplemental Application Forms <br /> FOR APCD USE ONLY: <br /> ' a ✓ <br /> RECEIVED:$ ^� CHECK#: <br /> ` ` a <br /> DATE PAID: r 02 y 9 A/•5. <br /> SNUAPT PROJECT : Q g3lp � , FACILITY ID: <br /> Northern Regional Office*4800 Enterprise Way*Modesto,California 95356-8718*(209)557-6400*FAX(209)557-6475 <br /> Central Regional Office*1990 Fast Gettysburg Avenue*Fresno,California 93726-0244*(559)230-5900*FAX(559)230-6061 <br /> Southern Regional Office*34946 Flyover Court*Bakersfield,California 93308*(661)392-5500*FAX(661)392-5585 <br /> Poultry CAF,pg 1 of 3 Jan.2009 <br />