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Part 5.COMPLIANCE WITH CALIFORNIA ENVIRONMENTAL QUALITY ACT(CEQA)(Check applicable boxes) <br /> A. CHECK BOXES)IF ENVIRONMENTAL DOCUMENT WAS OR WILL BE PREPARED FOR THIS PROJECT AND PROVIDE THE STATE CLEARINGHOUSE NUMBER(SCH#): <br /> ®ENVIRONMENTAL IMPACT REPORT(EIR)SCH# 90020924 <br /> NEGATIVE DECLARATION(ND)/MITIGATED NEGATIVE DECLARATION(MND)SCH# <br /> ADDENDUM TO(Identify environmental document) SCH# <br /> B. IF ENVIRONMENTAL DOCUMENT(S)WAS NOT PREPARED,PLEASE PROVIDE THE FOLLOWING INFORMATION: <br /> EDCATEGORICAUSTATUTORY EXEMPTION(CE/SE) <br /> EXEMPTION TYPE GUIDELINE p <br /> Part 6.LIST OF ATTACHMENTS(Fill in the date for each document checked) <br /> A.REQUIRED WITH ALL APPLICATION SUBMITTALS: <br /> ®RFI/JTD Revised pages attached ®ENVIRONMENTAL DOCUMENT(S):Previously Submitted <br /> ®LOCAL USE/PLANNING PERMITS Previously submitted ❑EIR 90020924 <br /> ®LOCATION MAP Previously submitted ❑MND/ND <br /> ®MITIGATION MONITORING IMPLEMENTATION SCHEDULE Previously submitted. ❑EXEMPTION <br /> ❑ADDENDUM <br /> B. ADDITIONAL REQUIRED DOCUMENTS FOR LANDFILLS ONLY: <br /> ®OPERATING LIABILITY FINANCIAL MECHANISM OFINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ®CLOSURE/POST CLOSURE MAINTENANCE PLAN ®LANDFILL CAPACITY SURVEY RESULTS(see instructions) <br /> ❑ PRELIMINARY <br /> ❑ FINAL <br /> C. IF APPLICABLE: <br /> ❑REPORT OF WASTE DISCHARGE DDEPT.OF HEALTH SERVICES PERMIT <br /> ®CONTRACT AGREEMENTS SWAT(Air and water) <br /> ®STORMWATER PERMIT APPLICATION ❑WETLANDS PERMITS <br /> ❑NPDES PERMIT APPLICATION ❑VERIFICATION OF FIRE DISTRICT COMPLIANCE <br /> OTHER <br /> Part 7.OWNER INFORMATION (For disposal site,if operator is different from land owner,attach lease or other agreement) <br /> TYPE OF BUSINESS: <br /> SOLE PROPRIETORSHIP ®PARTNERSHIP FLICORPORATION ®GOVERNMENT AGENCY <br /> OWNERS)OF LAND SSN OR TAX ID y <br /> (Name): <br /> USA WASTE OF CALIFORNIA dba Central Valley Waste Services 68-0306154 <br /> ADDRESS,CITY,STATE,ZIP TELEPHONE#: <br /> P.O.Box 241001,1333 East Turner Road,Lodi,California 95241-9501 209.333.5611 <br /> FAX p: <br /> 209-369-6894 <br /> E-MAIL ADDRESS: <br /> bwaters(-wm.com <br /> CONTACT PERSON(Print Name): <br /> Brian Waters, District Manager <br /> Page 3 <br />