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ATTACHMENT 3 <br /> State of California California Integrated Waste <br /> CIWMB FORM 5000 (revised 2/95) Management Board <br /> STANDARDIZED COMPOSTING PERMIT <br /> 1. Facility/Permit Number (SWIS): <br /> 2. Name of Facility: Address/Location: <br /> 3. Local Enforcement Address: <br /> Agency: <br /> 4. Signature of Local Enforcement Agency 6. Date of Signature: <br /> Approving Officer: <br /> 5. Please Print or Type Name and Title of <br /> Approving Officer: <br /> 7. Date Received by CIWMB: <br /> 8. Signature of CIWMB Approving Officer: 10. Date of Signature: <br /> 9. Please Print or Type Name and Title of <br /> Approving Officer: <br /> 11. Date of Permit Issuance: 12. Permit Review Due Date: <br /> LThefacility for which this permit has been issued shall only be operated in accordance with the description <br /> the application pursuant to Section 18105.1 and Report of Composting Site Information pursuant to <br /> 863. <br />