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STATE OF CALIF-ORNIA <br /> CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> REGIONAL WATER QUALITY CONTROL BOARD <br /> APPLICATION FOR SOLID WASTE FACILITY PERMIT/WASTE DISCHARGE REQUIREMENTS <br /> CIWMB E-1-77(Rev.8-04) <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 /> FOR OFFICIAL USE ONLY <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 /> County of San Joaquin, Environmental Health Department San Joaquin <br /> C.TYPE OF APPLICATION(Check one box only): <br /> Ell. NEW SWFP and/or WDRS 04.PERMIT REVIEW <br /> 2. REVISION OF SWFP and/or WDRS 05.AMENDMENT OF APPLICATION <br /> ❑3. EXEMPTION and/or WAIVER ®6.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 /> E-11.DISPOSAL 03.TRANSFORMATION ®5.OTHER(describe): Cannery Waste <br /> a. TYPE: <br /> XQ2.COMPOSTING ®4.TRANSFER/PROCESSING FACILITY <br /> a. TYPE: Green Waste X CHECK HERE IF RECYCLABLE MATERIALS ARE RECOVERED PRIOR TO TRANSFER/PROCESSING, <br /> D.CONFORMANCE FINDING INFORMATION(CIWMP): <br /> ®1.FACILITY IS IDENTIFIED IN(Check one): <br /> X❑SITING ELEMENT DATE OF DOCUMENT Mar-97 PAGE# <br /> ❑NONDISPOSAL FACILITY EL DATE OF DOCUMENT PAGE# <br /> O2.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 /> ®1.AGRICULTURAL ®6.CONSTRUCTION/DEMOLITION 1:111.LIQUIDS <br /> E]2.ASBESTOS ❑Friable ❑Non-friable E-17.CONTAMINATED SOILS ®12.MIXED/MUNICIPAL SOLID WASTE <br /> E-13.ASH 08.DEAD ANIMALS ®13.SEWAGE SLUDGE <br /> 04.AUTO SHREDDER -19.INDUSTRIAL ®14.TIRES <br /> 1:110.INERT X❑15.OTHER(describe): Appliances, u-Waste,a-Waste <br /> -15.COMPOSTABLE MATERIAL(describe): Green Waste <br /> Page 1 <br />