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San Joaquii. Valley Air Pollution Cc..trol District <br /> www.valleyair.org <br /> Permit Application For: <br /> AUTHORITY TO CONSTRUCT(ATC) -New Emission Unit <br /> AUTHORITY TO CONSTRUCT(ATC) -Modification Of Emission Unit With Valid PTO/Valid ATC <br /> AUTHORITY TO CONSTRUCT(ATC) - Ronewal of Valid Authority to Constnict <br /> PER TO OPERATE (PTU) - Exioting Emission Unit Now Requiring if Permit to 017erate <br /> I. PERMIT TO 111. ISSUED TO: C,,j M <br /> 2. MAIINGADDRESS: <br /> sTkr:QT/P n.BOX: - <br /> WDIOIT <br /> CITY: _t,:�l � � _- sTATR: zrnCODQ. -- <br /> .. LOCATION WI 11111 '1'11 i I Qt11P� NT WILL BE OPERATED: WITIUN 1,000 Fr OF A <br /> y'1'ItQQT: 1_L, —. 11_- CITY: �� - �'`� w SCHOOL? 1 Ylsti NO <br /> SIC,CnDF.(S)OF FACILITY <br /> _______4 BUCTION--___-_—� TOWN!!HU' RANOR <br /> .I, t'1PWRAI.NA111RE OF 1111yINESS: � �1��, INNTAI.1.I)A� l <br /> 5, '1'1'17,1? V 1'1;RMl'I'I IOLI)vit8 ONLY: leo you rayuast a COC:(EI'A Raviaw)prior to receiving your A' 'C Qr YES I I No 1 <br /> ru,«, +louvo c eim+Iota and nrlac•h a t'aui+/once Cor►l%Irtrhan lornt 7`I 7Gl 7111/.tl/Js)'� <br /> 6. DFSCRIPTION OF EQUIPMENT OR MODIFICATION FOR WHICH APPLICATION IS MADE(include Permit El's ifknowii.and use <br /> additional cheats if necessary) <br /> 7. PERMIT 1(EiVIEW 111-NIO ) Do you request a three-or ten-day period to review the droll Authority to Construct I I .1-day review <br /> purmit?Pluase note that elwuking"YES"will delay issuance of your final permit by u cotruspondinS numher of 0-day ruviuw <br /> \ua•kin duv,r' tied ulslruo Dons lin n)ore inli)rnuuion on this rcp iC\\ process. No reg rer nested <br /> S. HAVE YOU EVER APPLIED FOR AN ATC OR I ) YESNo Optional Section <br /> sPA <br /> PTO IN THE PAST? If yrs.ATC/PTC>#: _. 11 PIAIRTICI AMAN I-�11 tH ARE <br /> fir <br /> 1), I IAVE ALL NECENSARY LAND4114V TIMIM VOLUNTARY PKooaAMS C <br /> At1TIIORIZAT'ION9 I31i1iN Ol3'l'AINED? Y'ES I I No "SPARl: VE All(" <br /> (I/"'Nu"6v checked,/leave anuvh"planation) x I IYcs ViNo I ]Send inti) <br /> 10,IS'PHIS APPLICATION SU13MI'ITED ASTHE I )YES <br /> �4`NO "INSPECT" taSP <br /> RESULT'OF EI7TTIER A NOTICE'OF VIOLATION 1 1Yes I No I ISend inti) y <br /> OR A NOTICE TO COMPLY? If}rs.Nc►VMT'C 4: <br /> 12. TYPE OR PRINT NAME Vi:APPLICANT 1ITL?OF APPLE :ANT' r2rT i v)(=rte <br /> vik <br /> 1.3, NI(I i'11R1?t) A I'1,CAN°t°;��'`''� DKIV: 11IIt)NF N: ( '21-) 1?(..)'-4 , <br /> FAX a: (92rT er 7-3 - ISL' <br /> b t' h^MAIL.: 4: L1 UG � Z qL O -7 <br /> FOR APCD E ONLY; <br /> DATE..S'E'AMY: FILIN0 FEE' <br /> REC'E'IVED: S CHECK N:_. - - <br /> PRt I.1FC'I'a: FACILITY ID: <br /> Northern Regional Office*4230 Kiernan Avenue,Suite 130"Modesto,California 95356-9321 '(209)557-6400 w FAX(209)557-6475 <br /> Central Regional Office'" 1990 Fast Gettysburg Avenue" Fresno,California 93726-0244'(559)230-5900'"FAX(559)2:30-6061 <br />