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STATE OF CALIFORNIA CALIFORNIA WASTE MANAGEMENT BOARD SOLID WASTE FACILITIES PERMIT APPLICATION CWMB E-1-77(Rev.1/89) ENFORCEMENT AGENCY FOR ENFORCEMENT AGENCY USE ONLY Local Health District FILE NUMBER(PERMIT NUMBER) COUNTY 14 / — 2 o San Joaquin County DATE RECEIVED FILING FEE 6� TYPE OF APPUCATION W. 2811990® (�1.NEW SOLID WASTE ❑2.REVISION OF PERMIT ❑3.PERMIT REVIEW DATE ACCEPTED, RECEIPT NUMBER �I FACILITY PERMIT �2 , �9 ( ®4.MODIFICATION OF PERMIT ❑5.EXEMPTION FROM PERMIT [:]6. FACILITY CLOSURE DATE REJECTED CO SWMP REFERENCE PAGES) ❑7.AMENDMENT OF APPLICATION e NOTE: This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the enforcement agency. See instructions on back for completing this application. NAME OF FACILITY Forward Inc. Transfer Station LOCATION OF FACILITY(GIVE ADDRESS OR LOCATION.ALSO INCLUDE LEGAL DESCRIPTION BY SECTION,TOWNSHIP,RANGE,RASE AND MERIDIAN IF SURVEYED OR PROJECTED.) 9999 S. Austin Rd. , Manteca, CA, 95336 I. Section 3 , T1S, R7E MDB&M GENERAL TYPE OF FACILITY DESCRIPTION ❑ LANDFILL TRANSFER STATION ❑ RESOURCE RECOVERY FACILITY OF ❑ SUMP ❑ COMPOSTING ❑ LAND SPREADING FACILITY TYPE OF WASTES TO BE RECEIVED ❑X AGRICULTURAL ® CONSTRUCTION/DEMOLITION ® LIQUIDS(INCLUDES SEPTAGE) ❑ ASBESTOS DEAD ANIMALS ❑ MIXED MUNICIPAL ❑ ASH ® INDUSTRIAL ❑ SEWAGE SLUDGE ❑ AUTO SHREDDER ® INFECTIOUS ®TIRES ❑WOOD MILL II OPERATION ' EFFECTIVE DATE PROPOSED CHANGE(CHECK APPLICABLE BOX(ES)l L EFFECTIVE DATE FACILITY COMMENCED WILL COMMENCE ® ❑ F NA ® DESIGN ❑ OPERATION X❑ NO CHANGE E NA INFORMATION L L AVERAGE ANNUAL LOADING(TPY) 91 , 250 PEAK DAILY LOADING(TPD) 250 FACILITY SIZE(A) 2 8 EXPECTED CLOSURE YEAR_ NA III. OWNER OF LAND(NAME) F ADDRESS P.0. B ox 6336 TELEPHONE NUMBER OPERATOR Forward Inc. F Stockton,CA, 95206 (209)466-5192 INFORMATION FACILITY OPERATOR(NAME) 1 ADDRESS For land disposal,a Forward Inc. i P.0•BOX 6336 operator is different Stockton CA 95206 from land owner,attach ADDRESS WHERE LEGAL NOTICE MAY BE SERVED TELEPHONE NUMBER leaseor refranchise 1145 W. Charter Way, Stockton, CA, 95206 agreement 1 ( 209)466-5192 hereby acknowledge that I have read this application and the Report of Station or Disposal Site Information,and certify that the 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 conditions of the permit and with federal,state and local enactments. SIGNATURE(LAND OWNER OR AGENT) SIGNATU (FACILITY OPERATOR OR AGENT) YLA TYPEO NAMEUK TYPED NAM Gregory Basso Gregory Basso TITLE DATE TITLE DATE Vice President 3/28/90 Vice President 3/28/90 IV. LIST OF ATTACHMENTS(CHECK THOSE APPLICABLE) ❑ REPORT OF FACILITY INFORMATION(REQUIRED) ❑ ENVIRONMENTAL REVIEW REPORTS ❑CLOSURE PLAN ❑ PERIODIC SITE REVIEW ❑WASTE DISCHARGE REQUIREMENTS ❑OTHER REGULATORY AGENCY PERMITS ❑ LOCAL USE/PLANNING PERMITS(REQUIRED) 0 SWAT 0 OTHER