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Part 5.COMPLIANCE WITH CALIFORNIA ENVIRONMENTAL QUALITY ACT(CEQA)(Check applicable boxes) <br /> A. CHECK BOX(ES)IF ENVIRONMENTAL DOCUMENT WAS OR WILL BE PREPARED FOR THIS PROJECT: <br /> X� 1.ENVIRONMENTAL DOCUMENT WAS PREPARED: <br /> FENVIRONMENTAL IMPACT REPORT(EIR)SCH# SCH#93042093 <br /> NEGATIVE DECLARATION(ND)/MITIGATED NEGATIVE DECLARATION(MND)SCH# SCH#2011102013 <br /> EJADDENDUM TO(identify environmental document) n1a SCH# <br /> El 2.ENVIRONMENTAL DOCUMENT WILL BE PREPARED(Enter lead agency if known): <br /> B. IF ENVIRONMENTAL DOCUMENT(S)WAS NOT PREPARED,PLEASE PROVIDE THE FOLLOWING INFORMATION: <br /> I <br /> cATEGORICALISTATUTORY EXEMPTION(CEISE) i <br /> EXEMPTION TYPE GUIDELINE# <br /> I <br /> Part 6.LIST OF ATTACHMENTS(f=ill in the date for each document checked) <br /> i <br /> A-REQUIRED WITH ALL APPLICATION SUBMITTALS: <br /> xl RFIIJTD RFI-September 2023 X❑ ENVIRONMENTAL DOCUMENT(S): <br /> X❑ LOCATION MAP RFI-September 2023 im EIR SCH#93042093.1211611993 <br /> El MITIGATION MONITORING&REPORTING PROGRAM ©MND/ND SCH0011102013.212112 <br /> XX LIST OF PUBLIC HEARINGS AND OTHER MEETINGS OPEN TO THE PUBLIC February 2,2012 4 EXEMPTION <br /> July 24,2013 <br /> O ADDENDUM <br /> B, ADDITIONAL REQUIRED DOCUMENTS FOR DISPOSAL FACILITIES ONLY: <br /> ElOPERATING LIABILITY FINANCIAL MECHA,n1a El FINANCIAL RESPONSIBILITY DOCUMENTATION n1a <br /> El CLOSUREIPOST CLOSURE MAINTENANCE PLP n1a I I KNOWN OR REASONABLY FORSEEABLE CORRECTIVE ACTION COST ESTIMATES <br /> nla <br /> CI PRELIMINARY <br /> ❑FINAL F1 LANDFILL CAPACITY SURVEY RESULTS(see instructi n1a <br /> C. IF APPLICABLE: <br /> I <br /> REPORT OF WASTE DISCHARGE WQ 2015.0121-DWQ DEPT,OF TOXIC SUBSTANCES CONTROL OR CERTIFIED UNIFIED <br /> PROGRAM AGENCY PERMIT n1a <br /> STORMWATER PERMIT APPLICATION n1a SWAT(Alr and water) n1a <br /> NPDES PERMIT APPLICATION n1a El WETLANDS PERMITS n1a <br /> x] OTHER APCD PTO#N-3187.4-0VERIFICATION OF FIRE DISTRICT COMPLIANCE n1a <br /> Part 7.OWNER INFORMATION (For disposal site,If operator Is different from land owner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> 11 SOLE PROPRIETORSHIP PARTNERSHIP CORPORATION GOVERNMENTAGENCY <br /> OWNERS)OF LAND SSN ORTAX ID If <br /> (Name): <br /> Mike Repetto #680293953 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE M <br /> 30703 S.MacArthur Drive,Tracy,CA 95376 <br /> 209 835-0601 <br /> FAX#: <br /> (209)835-7729 <br /> E-MAIL ADDRESS: <br /> miker aAtdswm.com <br /> CONTACT PERSON(Print Name): <br /> , <br /> Mike Repetto j <br /> Page 3 <br /> 3t <br />