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APPLICATION FOR DEPARTM�N T OF THE ARMY PERMIT a OMB APPROVAL NO.07100-003 (33 C 5) � Expires October 19DS biic reporting burden for this collection of information is estimated to average 5 hours per response, including the time for reviewing instructions, arching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of information. Send rr7ants regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden,to ment of Defense,Washington Headquarters Service Directorate of Information Operations and Reports, 1215 Jefferson Davis Highway,Suite 1204, -p mon,VA 222fense,02-4302;and to the Office a Management and Budget,Paperwork Reduction Project(0710-003),Washington,DC 20503. Please DO NOT :TURN your form to either of these addresses. Completed applications must be submitted to the District Engineer having jurisdiction over the location tt}g,propased activity. PRIVACY ACT STATEMENT itarity:33 USC 40i,Section 10;1413,Section 404. Principal Purpose:These laws require permits authorizing activities in,or affecting,navigable iters of the United States,the discharge of dredged or fill material into waters of the United States,and the transportation of dredged material for the rp-se of dumping it into ocean waters. Routine Uses:Information provided on this form will be used in evaluating the application for a permit. s« sure:Disclosure of requested information is voluntary. If information is not provided,however,the permit application cannot be processed nar can p4 `nit be issued. reproducible copies which show re set of original drawings or good the location and character of the proposed activity must be attached to this f the district Engineer having jurisdiction over the location of the proposed activity: pl+cation(see sample drawings and instructions)and submitted to 4k plication that is not completed in full will be returned. TEMS 1 THRU 4 TO BE FILLED BY THE CORPS PLICATION NO. 2, FIELD OFFICE CODE 3, DATE RECEIVED 4. DATE APPLICATION COMPLETED E 'IT EMS BELO Ar FO BE FILLED EYAPPLICAN77 _ PLICANT"S NAME - City of Stockton Y 8. AUTHORIZED AGENT'S NAME AND TITLE (an agent is not required) Stephen Chen Jones & Stokes Associates, Inc. Deputy Public works Ellyn Davis, Project Manager Director/5W I ` Strt, Suite 100 APPLICT' ANS ADDRESS Department of Public works 9. AGENT'S ADDRESS 26000ramentoeeCA 95818-1914 425 North E1 Dorado Street - Stockton, CA 95202-1997 APPLICANT'S PHONE NOS.W/.AREA CODE 10. AGENT'S PHONE NOS.WIAREA CODE Residence a. Residence Business 209/937-8826 6, Business 915/737-3000 STATEMENT OF AUTHORIZATION f .5yauthorize, Ellyn Davis of Jones & Stokes to act in my behalf as my agent in the processing of this application and to furnish, F. on request,supplemental information in support of this permit application. 3(741 i� k + DTE APPLICANT'S SIGNATURE NAME LOCATION AND DESCRIPTION OF PROJECT OR ACTIVITY '..IROJECT NAME OR TITLE (see instructions) ur,tin Road Landfill Expansion Project sf NAME OF WATERBODY,IF KNOWN (if applicable) 14. PROJECT STREET ADDRESS (if applicable) ittlejohns Creek OCATION OF PROJECT ' San Joaquin ^ California u COUNTY STATE )THER LOCATION DESCRIPTIONS,IF KNOWN,(see instructions) ownship 1 'South, Range 7 East, north half of Section 3 nship 1 North, •Range 7 East, south half of Section 34 DIRECTIONS TO THE SITE rsupplemental information sheet EDITION OF SEP 91 IS OBSOLETE (Proponent:CECW-OR) FORM 4345,Feb 94 F