Laserfiche WebLink
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 AND PROVIDE THE STATE CLEARINGHOUSE NUMBER(SCHN <br /> ENVIRONMENTAL IMPACT REPORT(EIR)SCHN <br /> ®NEGATIVE DECLARATION(NDpMITIGATED NEGATIVE DECLARATION(MND)SCHN 2010112045 <br /> QADDENDUM TO(identity environmental document) SCHN <br /> B. IF ENVIRONMENTAL DOCUMENT(S)WAS NOT PREPARED,PLEASE PROVIDE THE FOLLOWING INFORMATION <br /> [—]rATEGORICAL/STATUTORY EXEMPTION(CE/SE; <br /> EXEMPTION TYPE GUIDELINE N <br /> Part S.LIST OF ATTACHMENTS(Fill in the date for each document checked) <br /> A.REQUIRED WITH ALL APPLICATION SUBMITTALS: <br /> ®RFI/JTD Amended pages,tures,and drawings(see Part 10) ®ENVIRONMENTAL DOCUMENT(Sj. <br /> ®LOCAL USE/PLANNING PERMITS Apr-03 O EIR <br /> ®LOCATION MAP Included as Shest 1 o114 of Amended Pages X MND/ND SCHN 2010112045 <br /> ®MITIGATION MONITORING IMPLEMENTATION SCHEDULE Dec-02 O EXEMPTION <br /> O ADDENDUM <br /> B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br /> ®OPERATING LIABILITY FINANCIAL MECHANISM_,.,, May 2008 [K]FINANCIAL RESPONSIBILITY DOCUMENTATION Fets06 <br /> [j]CLOSURE/POST CLOSURE MAINTENANCE PLAKX�LANDFILL CAPACITY SURVEY RESULTS(see instructions) Mar-11 <br /> X PRELIMINARY In Appendix Lot JTD dated 512002 <br /> O FINAL <br /> C. IF APPLICABLE: <br /> REPORT OF WASTE DISCHARGE ®DEPT.OF HEALTH SERVICES PERMIT <br /> CONTRACT AGREEMENTS ®SWAT(Air and water) <br /> ®STORMWATER PERMIT APPLICATION ❑WETLANDS PERMITS <br /> ®NPDES PERMIT APPLICATION MVERIFICATION OF FIRE DISTRICT COMPLIANCE <br /> ®OTHER <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 ®GOVERNMENT AGENCY <br /> OWNER(S)OF LAND SSN OR TAX ID N <br /> (Name): <br /> Forward, Inc. 941544481 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE N: <br /> 209.982.4298 <br /> FAX N: <br /> 209.982.1009 <br /> 9999 S.Austin Road, Manteca, CA 95336 E-MAILADDRESS- <br /> dlitchfieId@republicservices.com <br /> CONTACT PERSON(Print Name): <br /> Don Litchfield <br /> Page 4 <br />