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STATE OF CALIFORNIA CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> SOLID WASTE FACILITIES PERMIT PLICATION <br /> CNVMB E-1-77(REV.6/92) <br /> ENFORCEMENT AGENCY: FOR ENFORCEMENT :.'ENCY USE ONLY <br /> �Lvironmental Health Division ���TED:—° <br /> San Joaquin FILING FEE <br /> --. <br /> 0 1. NEW SOLID WASTE FACILITY PERMIT ®4.MODIFICATION OF PERMIT ®7.AMENDMENT OF APPLICATION <br /> IWMP REFERENCE PAGE(S): <br /> 102. REVISION OF PERMIT S. EXEMPTION FROM PERMIT <br /> 113. PERMIT REVIEW 06. FACILITY CLOSURE <br /> NOTE: This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the <br /> local enforcement agency. See instructions for completing this application. <br /> L GENERAL NAME OF FACILITY: California Waste Removal Systems (CWRS) , Inc. <br /> DESCRIPTION LOCATION OF FACILITY:(Give address or location.also include legal description by section,township,range,base.and <br /> OF meridian if surveyed or projected. <br /> FACILITY <br /> TYPE OF FACILITY: ®LANDFILL ®PROCESSING FACILITY ®MATERIAL RECOVERY FACILITY <br /> ®SUMP ®TRANSFER STATION ❑LAND SPREADING <br /> TRANSFORMATION ®COMPOSTING <br /> L AJ <br /> FACILITY (MIXED WASTES) <br /> TYPE OF WASTES TO BE RECEIVED: <br /> ®AGRICULTURAL ❑DEAD ANIMALS ®TIRES <br /> ®ASBESTOS INDUSTRIAL ®W000 MILL <br /> MASH LIQUIDS(INCLUDES SEPTAGE) ❑OTHER DESIGNATED WASTE <br /> AUTO SHREDDER MIXED MUNICIPAL ®OTHER HAZARDOUS WASTE <br /> ®CONSTRUCTION/DEMOLITION ®SLUDGE OTHER:(DESCRIBE) <br /> IL FACILITY PROPOSED CHANGE EFFECTIVE DATE <br /> INFORMATION ®COMMENCED (CHECK APPLICABLE BOXES) OF PROPOSED CHANGE: <br /> Date: ®DESIGN <br /> WILL COMMENCE ®NO CHANGE April 1997 <br /> Date: <br /> ®OPERATION <br /> AVERAGEANNUALPEAK DAILY FACILITY SITE CAPACITY EXPECTED CLOSURE DATE. <br /> LOADING(TPY):24 LOADING(TPD): 1700 ISIZE(A): 16.48 IN YARDS: 2,914,286 <br /> I t.-, ESS: I r-Lt-HONE NU ib . <br /> INFORMATION (Name): <br /> For land disposal, CWRS 1333 E. Turner Road, Lodi, CA 95241-9501 (209) 369-8274 <br /> if operator is FACIU iUR AUDREM: <br /> different from (Name): Thomas <br /> land owner,attach A San hez 1333 E. Turner Road Lodi CA 95241--9501 (209) 369-8274 <br /> lease or franchise ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: TELEPHONE NUMBER: <br /> agreement I. "Same° "Same" <br /> I hereby acknowledge that I have read this application and the Report of Facility Information, and certify that the information given is <br /> true and accurate to the best of my knowledge and belief. in operating the solid waste facility, 1 agree to comply with the conditions <br /> of the permit and with federal, state, and local enactments. <br /> SIGMA (LA OWNER OR AG T): SIGNATUC OPERATORAGEN <br /> PED NAME: TYPED NAME: <br /> Thomas A. Sanchez Thomas A. Sanchez <br /> TITLE. Division General Mana er DATE. TITLE: DiViSian GoMr-al TE: �� 77 <br /> IV.LIST OF ATTACHMENTS(CHECK IF APPLICABLE): <br /> REPORT OF FACILITY INFORMATION ®SWAT(AIR AND WATER) <br /> ®PERIODIC SITE REVIEW ®STORMWATER DISCHARGE PERMITS(NPOES) <br /> LOCAL USE/PLANNING PERMITS WETLANDS PERMIT <br /> ®OPERATING LIABILITY FINANCIAL MECHANISM PRELIMINARY CLOSUREIPOSTCLOSURE MAINTENANCE PLAN <br /> ❑DEPARTMENT OF HEALTH SERVICES PERMIT ®FINAL CLOSURElPOSTCLOSURE MAINENANCE PLAN <br /> ®AIR QUALITY/POLLUTION CONTROL DISTRICT PERMITS ®FINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ®CERTIFIED ENVIRONMENTAL REVIEW REPORTS(CEQA) OOTHER REGULATORY AGENCY PERMITS <br /> ®WASTE DISCHARGE REQUIREMENTS ®OTHER <br /> (PERMITALS6192) <br />