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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 /> ✓❑ 1.ENVIRONMENTAL DOCUMENT WAS PREPARED: <br /> ZENVIRONMENTAL IMPACT REPORT(EIR)SCH# 9209072 February 1994 <br /> NEGATIVE DECLARATION(ND)/MITIGATED NEGATIVE DECLARATION(MIND)SCH# <br /> ElADDENDUM TO(Identify environmental document) 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 /> f7 CATEGORICAL/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 /> ✓❑ RFI/JTD 05/08/2026 �✓ ENVIRONMENTAL DOCUMENT(S): <br /> El LOCATION MAP m EIR 02/01/1994 <br /> ElMITIGATION MONITORING&REPORTING PROGRAM ❑MND/ND <br /> EJ LIST OF PUBLIC HEARINGS AND OTHER MEETINGS OPEN TO THE PUBLIC ❑EXEMPTION <br /> ❑ADDENDUM <br /> B. ADDITIONAL REQUIRED DOCUMENTS FOR DISPOSAL FACILITIES ONLY: <br /> ElOPERATING LIABILITY FINANCIAL MECHANISM EJ FINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ElCLOSURE/POST CLOSURE MAINTENANCE PLAN KNOWN OR REASONABLY FORSEEABLE CORRECTIVE ACTION COST ESTIMATES <br /> ❑PRELIMINARY <br /> ❑FINAL ❑ LANDFILL CAPACITY SURVEY RESULTS(see instructi <br /> C. IF APPLICABLE: <br /> ElREPORT OF WASTE DISCHARGE DEPT.OF TOXIC SUBSTANCES CONTROL OR CERTIFIED UNIFIED <br /> PROGRAM AGENCY PERMIT <br /> ElSTORMWATER PERMIT APPLICATION SWAT(Air and water) <br /> ElNPDES PERMIT APPLICATION El WETLANDS PERMITS <br /> OTHER El 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 El PARTNERSHIP CORPORATION p✓ GOVERNMENTAGENCY <br /> OWNER(S)OF LAND SSN OR TAX ID# <br /> (Name): <br /> San Joaquin County,Department of Public Works-Solid Waste Division 946000531 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE#: <br /> PO Box 1810,Stockton,CA 95201 2094683066 <br /> FAX#: <br /> 094683078 <br /> E-MAIL ADDRESS: <br /> mhoughton@SJGOV.org <br /> CONTACT PERSON(Print Name): <br /> Mark Houghton <br /> Page 3 <br />