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• • State of California • Department of Resources Recycling and Recovery (CalRecycle) RFI Amendment Determination Checklist Cal6ecycle CalRecycle 216 (Revised 9%16) Attached are the following items: ❑ JTD Index ❑ Application form ❑ A copy of the RFI Amendment ❑ New CEQA documentation since the last permit was issued (including any exemptions) ❑ Other: Date of LEA received package: Date LEA denied RFI Amendment: Date LEA accept RFI Amendment: The LEA determination should answer the following questions: 1) What are the changes covered by the RFI Amendment?.............. ........................................................... El Yes ❑ No 2) Is the proposed change(s) consistent with CEQA?................................................................................... ❑ Yes ❑ No What CEQA documents were used to determine this? Additional Information: * Completion of this form is not required by regulation, however, it will provide CalRecycle with the information required by 27 CCR 21665. Has the LEA determined that the change would not create any adverse environmental impacts and isexempt from CECIA?...................................................................................................... ........................ Yes No ❑ ❑ What exemption classification did the LEA or other lead agency use? 3) Does the proposed change impact the facility's ability to comply with financial assurances and 4) operating liability? .................. ............................... ................................................................. Is the proposed change consistent with state F-1 Yes [:] No minimum standards? ............................. ......................... Will the change exacerbate any current compliance problems at the facility?........... ............................ Yes No ❑ Yes ❑ [] No Would implementation of the change effect the operator in complying with any enforcement order? (] Yes ❑ No 5) Does this change conflict with any part of the governing permit?.......................................................... ❑Yes [] No 6) Will the proposed change in the RFI Amendment require the operator to amend the 7) closure post closure plan? ................... ............................................................................. .............. .......... Any ❑ Yes F1No additional information required by the operator: Additional Information: * Completion of this form is not required by regulation, however, it will provide CalRecycle with the information required by 27 CCR 21665.