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STATE OF CALIFORNIA <br /> CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> REGIONAL WATER QUALITY CONTROL BOARD <br /> APPLICATION FOR SOLID WASTE FACILITY PERMITMASTE DISCHARGE REQUIREMENT <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 /> SIMS NUMBER: FILING FEE: RECEIPT NUMBER: DATE REC IVED: <br /> �4 leg <br /> DATE ACCEP ED: DATE REJECTED: ACCEPTANCE DATE OF <br /> ^ �� INCOMPLETE APPLICATION: <br /> l(T••�/( DATE DUE: <br /> Part 1.GENERAL INFORMATION <br /> A.ENFORCEMENT AGENCY: B.COUNTY: <br /> San Joaquin County Environmental Health Division San Joaquin County <br /> C.TYPE OF APPLICATION(Check one box only): <br /> n 1. NEW SWFP and/or WDRS n4.PERMIT REVIEW <br /> ❑2. REVISION OF SWFP and/or WDRS ❑5.AMENDMENT OF APPLICATION <br /> 03. EXEMPTION and/or WAIVER F✓6.RFI/ROWD/JTD AMENDMENTS <br /> Part 2. FACILITY DESCRIPTION <br /> A. NAME OF FACILITY: Forward Resource Recovery Facility <br /> B. LOCATION OF FACILITY: <br /> 1. PHYSICAL ADDRESS OR LOCATION AND ZIP CODE: 9999 South Austin Road,Manteca,California <br /> 2. LATITUDE AND LONGITUDE: Latitude=37.87167 Longitude=-121.1848 <br /> 3.LEGAL DESCRIPTION OF PERMITTED BOUNDARY BY SECTION,TOWNSHIP,RANGE,BASE,AND MERIDIAN,IF SURVEYED: Section 3 of Township 1S,Range 7E,Mount <br /> Diablo Baseline and Meridian(MDB&M). Assessor Parcel No.201-060-03. <br /> C.TYPE OF ACTIVITY:(Check applicable boxes): <br /> F-T.DISPOSAL E-13.TRANSFORMATION F-15.OTHER(describe): <br /> a. TYPE: <br /> M2.COMPOSTING E714.TRANSFER/PROCESSING FACILITY <br /> a. TYPE:Any decomposable organic r7� CHECK HERE IF RECYCLABLE MATERIALS ARE RECOVERED PRIOR TO TRANSFER/PROCESSING. <br /> material described in RCSI Section 1.3 <br /> D.CONFORMANCE FINDING INFORMATION(CIWMP): <br /> M1.FACILITY IS IDENTIFIED IN(Check one): <br /> SITING ELEMENT DATE OF DOCUMENT PAGE# <br /> F✓ NONDISPOSAL FACILITY ELEMENT DATE OF DOCUMENT:March 1995 PAGE# <br /> F2.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 /> M1.AGRICULTURAL 716.CONSTRUCTION/DEMOLITION F-111.LIQUIDS <br /> F-12.ASBESTOS ❑Friable O Non-friable F-17,CONTAMINATED SOILS El12.MIXED/MUNICIPAL SOLID WASTE <br /> F✓ 3.ASH E-18.DEAD ANIMALS r7113.SEWAGE SLUDGE(Biosolids) <br /> F-14.AUTO SHREDDER ✓19.INDUSTRIAL F-114.TIRES <br /> r71110.INERT n 15.OTHER(describe): <br /> M5.COMPOSTABLE MATERIAL(describe):green material(and mixed with food waste) wood waste,food waste,food processing residue.manur <br /> Page 1 <br />