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Part 6. 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 AND PROVIDE THE STATE CLEARINGHOUSE NUMBER (SCH#): <br />®ENVIRONMENTAL IMPACT REPORT (EIR) SCH# 2001052081 (dated 2002) <br />❑NEGATIVE DECLARATION (ND)/MITIGATED NEGATIVE DECLARATION (MND) <br />❑ADDENDUM TO (Identify environmerital document): <br />B. IF ENVIRONMENTAL DOCUMENT(S) WAS NOT PREPARED, PLEASE PROVIDE THE FOLLOWING INFORMATION: <br />F-1CATEGORICAL/STATUTORY EXEMPTION (CE/SE) <br />EXEMPTION TYPE GUIDELINE # <br />Part 6. LIST OF ATTACHMENTS (Fill in the date for each document checked) <br />A. REQUIRED WITH ALL APPLICATION SUBMITTALS: <br />�RFIIJTD: Recon of Comoosdnc Site Infoanation (RCSI) (dated 2014): <br />®ENVIRONMENTAL DOCUMENT(S): <br />1 ranter/Ptocessmg KapOrt (dated "1014). <br />LOCAL USE/PLANNING PERMITS: <br />0 EIR SCH# 2001052081 dated December 2002 <br />®LOCATION MAP: Figure 2 in RCSI (dated 2014) <br />❑ MND/ND <br />©MITIGATION MONITORING IMPLEMENTATION SCHEDULE: December 2002 <br />❑ EXEMPTION <br />1] ADDENDUM <br />B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br />❑OPERATING LIABILITY FINANCIAL MECHANISM: ®FINANCIAL RESPONSIBILITY DOCUMENTATION: <br />MCLOSURE/POST CLOSURE MAINTENANCE PLAN ®LANDFILL CAPACITY SURVEY RESULTS (see instructions) <br />M PRELIMINARY/FINAL <br />C. IF APPLICABLE: <br />REPORT OF WASTE DISCHARGE ®DEPT. OF HEALTH SERVICES PERMIT <br />MCONTRACT AGREEMENTS ®SWAT (Air and water)_ <br />MSTORMWATER PERMIT APPLICATION ®WETLANDS PERMITS <br />❑NPDES PERMIT APPLICATION ®OTHER: <br />❑VERIFICATION OF FIRE DISTRICT COMPLIANCE <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 />SOLE PROPRIETORSHIP PARTNERSHIP ✓ CORPORATION <br />OWNER(S) OF LAND <br />Forward Inc. <br />STATE, ZIP: 9999 S. Austin Road, Manteca, CA 95336 <br />11GOVERNMENTAGENCY <br />SSN OR TAX ID # <br />941544481 <br />TELEPHONE #: (209) 982-4298 <br />FAX#: (209)982-1009 <br />E-MAIL ADDRESS: Efanning@repubiicservices.com <br />CONTACT PERSON (Print Name): <br />Erin Fannina <br />Page 3 <br />