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(Refer to 3/2/90 Re l <br /> port of Waste Discharge.) , ._ ,f• <br /> A. PRESENT ORRO►OS D I rwxlrur I wv6R was I a. OESION FLOW IN MOD `®'•� <br /> DAILY FLOW �IN MOD$; I I I <br /> C. (OLID BASTE DISPOSAL ( DAILY RuwNTr7T I TOTAL IN OLA66 OVANTIYY WHII �L s/ Aw6e <br /> SITE(IN TONS OR I I (IN ACRES) <br /> CuEtC YARDS): <br /> V11. LOCATION OF POINT OF OIIWOS:AL OR OPERATION <br /> (DESIQN AND ATTACK MAP,SKETCH.OR LOCATION ON U.S,Q.S.QUADRANGLE NAP,r.l OR /f MINU76 SC RIif.) <br /> LIST DISTANCES OR SCARING AND DISTANCE FROM SCCTtON CORNER OR QUARTER CORNER.SECTION.TOWNSHIP.RANGE.■ASE AND MCRID1AN: <br /> VIIL SOURCE OF WATER SUPPLY (CNCCK ALL AP►RO►04IAr61 _Rv! -" <br /> A. MUNICIPAL OR UTILITY SERVICE: B. E] INDIVIDUAL(Wells) <br /> NAME OF WATER PURY6YOR <br /> C. ® SURFACE SUPPLY: <br /> AOOA666 OF«u Rwevon NAYS W STR6A./,LAKE,f.*INR,STC. IF AMUD <br /> TT16 OP WATER 11M.TH WAT60 RIOKTS IS*rIT OR LIC6Nl6 1 <br /> ® Riparian n Appropriation 11 <br /> I <br /> IX. ENVIRONMENTAL IMPACT REPO*I IEIRI - <br /> Hes an EIR been prepared for this project? ❑ Yes No <br /> If"Yes",pleats enclose a copy. <br /> If"No",will an EIR be prepared? Yes No <br /> Will a negative declaration be prepared? Yes t__i No <br /> If"Yes".please answer the following. WNO 1&1—1*61^16 TNS"a6-116 06CLA-111"1 A..R ow.OAr6 O« 'OM.L6 rlOr <br /> CERTIFICATION <br /> 1 hereby certify under penalty of perjury that the information provided in this application and in any attach- <br /> ments is true and accur9te to the best of my knowledge. <br /> BtGN ATURE OF OWIeE OF TT SIGNAT E OF OPERATOR OF FACILITY <br /> .RIN.Ro <br /> on Tv.60 NwMR • o oa-;Z <br /> 6 <br /> l ' <br /> li `' 'eWarren on <br /> TITLE OATS TITLe OATS <br /> 9 18 91 Ti.W.T.P. SIMriat Ma" 9 8 91 <br /> LOST TITLES OF ANY ATTACHMENTS: <br /> NPDES Application for Permit to Discharge Wastewater Dated 3/2/90 <br /> You will be notified of the corractrMra of filing fee and submittal of any additionst information deemed necessary to complete your Report of Wash: <br /> Disehw" pursuant to Ohrision 7, Section 13250 of the State Water Coda,or to comdete your permit aopllcatlon pursuant to Government COLIC <br /> Section 66796.30 and Health and Safety Code Section 25200. <br />