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ARCHIVED REPORTS_2011_25
Environmental Health - Public
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4400 - Solid Waste Program
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ARCHIVED REPORTS_2011_25
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Last modified
7/18/2020 12:45:50 AM
Creation date
7/3/2020 10:56:22 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4400 - Solid Waste Program
File Section
ARCHIVED REPORTS
FileName_PostFix
2011_25
RECORD_ID
PR0440005
PE
4433
FACILITY_ID
FA0004516
FACILITY_NAME
FORWARD DISPOSAL SITE
STREET_NUMBER
9999
STREET_NAME
AUSTIN
STREET_TYPE
RD
City
MANTECA
Zip
95336
APN
20106001-3, 5
CURRENT_STATUS
01
SITE_LOCATION
9999 AUSTIN RD
P_LOCATION
99
P_DISTRICT
004
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\SW\SW_4433_PR0440005_9999 AUSTIN_2011_25.tif
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EHD - Public
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AAk <br /> Part 8.OPERATOR INFORMATION(For disposal site,if operator Is different from land owner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> SOLE PROPRIETORSHIP ®PARTNERSHIP X❑CORPORATION GOVERNMENT AGENCY <br /> FACILITY OPE RATOR(S) SSN OR TAX ID 9: <br /> (Name): <br /> Forward, Inc. 941544481 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE M <br /> 209.982.4298 <br /> FAX A: <br /> 209.982.1009 <br /> 9999 S. Austin Road, Manteca,CA 95336 E-MAIL ADDRESS: <br /> diitchfield @ rep ublicservices.com <br /> CONTACT PERSON(PAM Name): <br /> Don Litchfield <br /> ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: <br /> 9999 S Austin Road,Manteca,CA 95336 <br /> Part 9.SIGNATURE BLOCK <br /> Owner: <br /> I certify under penalty of penury that the information I provided for this application and for any attachments is true and accurate to the best of my knowledge and belief. 1 <br /> am aware that the operator intends to operate a solid waste facility at the site specified above pursuant to this application and understand that I may be responsible for the <br /> site should the operator fail to=t applicable requirements. <br /> SI URE(LAND NER OR AGENT): <br /> PRINTED NAME <br /> TITLE: C� .y, DATE 3�I <br /> erator: t <br /> I certify under penalty of perjury that the information contained in this application and all attachments are true and accurate to the best of my knowledge and belief. <br /> SIGNATURE(FACILOY OPERAT9RCR AGENT): <br /> PRI D NAM <br /> TITLE: DATE: <br /> Part 10.OTHER (Attach additional sheets to explain any responses that need clarification). <br /> Revised JTD pages include Section 2.2,2.3,2.4,4.6,and 4.7;Shts 1,2,3,4,5,9,10,11,and 13 of 14;Figures 7 and 10;Tables 3,1 <br /> Appendix C <br /> Page 5 <br />
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