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SOLE PROPRIETORSHIP <br />V.OPERATOR OW <br />INFORMATION (Na <br />For land disposal, <br />if operator is FA( <br />TYPE OF BU OPERATING FACILITY: <br />�PARTNE PX❑CORPORATION F-�GOVERNMENTAGENCY <br />OF LAND ADDRESS: TELEPHONE #: SSN OR TAX ID # <br />Michael P.O. Box 93, Tracy, CA 95378 209.832.2355 680293953 <br />Repetto <br />f OPERATOR ADDRESS: TELEPHONE #: SSN OR TAX ID #: <br />different from (Name): Michael 209.832.2355 680293953 <br />land owner, attach Repetto P.O. Box 93, Tracy, CA 95378 <br />lease or franchiser7! <br />HERE LEGAL NOTICE MAY BE SERVED: <br />agreement. P.O. Box 93, Tracy, CA 95378 <br />1 hereby acknowledge that I have read this application and the Report of Facility Information, if applicable, JTD or ROWD and certify that the <br />information given is true and accurate to the best of my knowledge and belief. In operating the solid waste facility, I agree to comply with the <br />conditions of theit and with federal, state, and local enactment's. <br />SIGNATUR LANDpermER OR AGENT): SIGNATURE (FACILITY_OPEPATOR §$ AGENT): _1-9 <br />Michael <br />Michael <br />Owner <br />Im <br />VI. LIST OF ATTACHMENTS (CHECK IF APPLICABLE): <br />REPORT OF FACILITY INFORMATION OPERATING LIABILITY FINANCIAL MECHANISM <br />REPORT OF WASTE DISCHARGE PRELIMINARY CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br />F-jJTD (RDSI/ROWD) FINAL CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br />F-ICONTRACTAGREEMENTS❑FINANCIAL RESPONSIBILITY DOCUMENTATION <br />®DEPARTMENT OF HEALTH SERVICES PERMIT ®OTHER REGULATORY AGENCY PERMITS <br />®LOCAL USE/PLANNING PERMITS X—JOTHER DESCRIPTION OF CHANGE <br />F—JCERTIFIED ENVIRONMENTAL REVIEW REPORTS (CEQA) SEE BELOW <br />INFORMATION ON THE STATUS OF THE APPLICANT'S COMPLIANCE WITH CEQA REQUIREMENTS REGARDING <br />THE PROPOSED PROJECT. <br />❑EVIDENCE THAT THERE HAS BEEN COMPLIANCE WITH CEQA PRC, DIVISION 13, 2100 et.sec <br />version 4 - 6/96 <br />ATTACHMENT "A" DESCRIPTION OF CHANGE <br />DELETE LEA CONDITION 17-M AND REPLACE WITH THE FOLLOWING: <br />Personnel working with the load screening program shall be trained to recognize hazardous wastes. <br />All employees shall be provided with personal protective safety equipment. <br />