Laserfiche WebLink
Attachment 3 <br /> jTATE OF CALIFORNIA <br /> I REGION,AL WATER QUALITY CONTROL BOARD <br /> DEPARTMENT OF HEALTH SERVICES <br /> SOLID WASTE MANAGEMENT BOARD <br /> ` DEPARTMENT OF FORESTRY •i <br /> J APPLICATION FOR <br /> FACILITY PERMIT/WASTE DISCHARGE <br /> This form is to be used for filing a/an: (check all appropriate) FOR OFFICE'USE tllVUNLY <br /> 1, ❑ REPORT OF WASTE DISCHARGE Form 200 Recd _ <br /> (pursuant to Division 7 of the State Water Code) Fee(RWOCB! _(SWMBI— _ <br /> 2. ® APPLICATION FOR A HAZARDOUS WASTE FACILITY PERMIT Letter to Discharger <br /> (pursuant to Health and Saiety Code Section 25200) <br /> 3. lR.l APPLICATION FOR A SOLID WASTE FACILITIES PERMIT Report Recd _ <br /> (pursuant to Government Code Section 66795.30) Effective Date <br /> 4. F-1 APPLICATION FOR A RUBBISH DUMP PERMIT CDF Notified <br /> (pursuant to Public Resources Code Sections 4371-4375 and 44381 OOHS No._ <br /> —— SWMB No. <br /> 1. FACILITY <br /> A. NAMU OF FACILITY <br /> TiLG PRONn • <br /> Corral Hollow Sanitary Landfill ( 209 ) 835-3167 <br /> soowsmm — <br /> s/P Coon <br /> 31130 S. Corral Hollow Road, Tracy 95376 <br /> R. NAMe OF LEGAL OWHRR OF FACILITY <br /> raba►RORa• <br /> City of Tracy, Department of Public Works ( 209 ) 836-4420 <br /> aooNass <br /> s1P coos <br /> City Hall Annex, 520 Tracy Blvd. , Tracy95376 <br /> C. "Able OF OYalN eaa OFe;RATING FACILITY <br /> T968PN ism• <br /> City of Tracy, Department of Public Works ( 209 836-4420 <br /> Ao'onasa <br /> GIP coon <br /> City Hall Annex, 520 Tracy Blvd. , Tracy 95376 <br /> O. TYPe OF RUNINeea OPe RATING FACILITY <br /> ElSole Proprietorship ® Partnership ® Corporation ® Government Agency <br /> a. NAME OF OWNER a OF®Ue1HEee OP[RATINO FACILITY <br /> Tabs PRONG O <br /> City of Tracy, Department of Public Works ( 209 , 836-4420 <br /> AOORUmm WRONG LUOAL NOVICK NAV na aAAVaO <br /> :v soca <br /> City Hall Annex, 520 Tracy Blvd. , Tracy 953oo <br /> /1. REASON FOR FILIMG <br /> CHOCK ALL APPAOPA/ATO: <br /> A. Now discharge or facility D. Change in character of discharge G. Change in business operating facility <br /> B. Existing discharge or facility E. Change in place or method of disposal H. Enlargement of existing facility <br /> C. Increase in quantity of discharge F. Change in design or operation 1. X Other(explain below) <br /> �_- Filing Application for Permit Review (RDSI and 5 year Engineering Review will follow) <br /> Its. Tyra or OPERATION <br /> CHOCK ALL APPNOPK1AVat <br /> A. Transfer station D. S treatment G. Woodwaste site <br /> B. X Solid waste disposal site E. Industry(on-site disposal facility) H. Other(explain below) <br /> C. Hazardous waste disposal site F. Industry(discharge to sewer) <br /> CHECK ALLAPIROPR1ATOi IV. TYPa Or WASTE <br /> A. Seam,sewage sludge,and/or E. X Agricultural wastes 1. X Inert materials <br /> S= <br /> tank pulnpings <br /> B. I X I Industrial wastes F. Animal wastes J. Dead animals <br /> C. X 1 Municipal solid wastes G. X Forest product wastes K. X Tires <br /> D. Hazardous wastes H. X Construction/demolition wastes I.. Other(explain below) <br /> _^ <br /> A,IA660NT POPUV. SITE DESIGN CAPACITY <br /> POPULATION V. <br /> CAPACITY O,139810NITVa910N POPULAT/aN OR 61LTIMATG CAPACCl '4.3 MFa aKPOCTANCV VaAAn <br /> 2,000,000 CY in place 2,800,000 CY in place <br /> FORM zoo (Rev.sp®) (OVER) <br />