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r-ENrCEMENT <br /> r CALIFORNIA St id CALIFORNIA INTEp "TD WASTE MANAGEMENT BOARD <br /> WA,,,-,T-,- FACILITIES PER 'PLICATION <br /> MGENCY: FOR ENFORCEMENT AGENCY USE ONLY <br /> Environmental FILE NUMBER(PERMIT NUMBER) DATE RECEIVED: <br /> Public Health Services , lipalth J2jyjaiQn DATE ACCEPTED: <br /> COUNTY: DATE REJECTED:��' <br /> San Joaquin FILING FEE: <br /> TYPE OF APPLICATION: RECEIPT NUMBER: <br /> CO SWMP!COUNTYWIDE <br /> i. NEW SOLID WASTE FACILITY PERMIT O4. MODIFICATION OF PERMIT ®7.AMENDMENT OF APPLICATION IWMP REFERENCE PAGE(S): <br /> �2. REVISION OF PERMIT ®5. EXEMPTION FROM PERMIT <br /> �3. PERMIT REVIEW ED 8. FACILITY CLOSURE <br /> NOTE:This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the <br /> local enforcement agency. See instructions for completing this application. <br /> 1. GENERAL NAME OF FACILITY: Forwardu e RpS;ovpry Facility <br /> DESCRIPTION LOCATION OF FACILITY: (Give address or location.also Include legal description by section,township,range,base,and <br /> OF meridian If surveyed or projected. S e c t i on 3 , T I S, R 7 E, MDBM; 9999 S Austin Rd. <br /> FACILITY ' <br /> TYPE OF FACILITY: ®LANDFILL OPROCESSING FACILITY ®MATERIAL RECOVERY FACILITY <br /> SUMP ®TRANSFER STATION LAND SPREADING <br /> TRANSFORMATION ®COMPOSTING <br /> FACILITY (MIXED WASTES) <br /> TYPE OF WASTES TO BE RECEIVED: <br /> ®AGRICULTURAL CDDEAD ANIMALS ®TIRES <br /> ®ASBESTOS ®INDUSTRIAL ®WOOD MILL <br /> ®ASH ®LIQUIDS(INCLUDES SEPTAGE) ®OTHER DESIGNATED WASTE <br /> ®AUTO SHREDDER '®MIXED MUNICIPAL ❑OTHER HAZARDOUsee the <br /> aCONSTRUCTION/DEMOLITION ®SLUDGE DOTTIER:(DESCR1W RSI <br /> if. FACILITY PROPOSED CHANGE EFFECTME DATE <br /> INFORMATION QX COMMENCED [CHECK APPUCABLE BOXES1 OF PROPOSED CHANGE <br /> Date: 19 7 8 ®DESIGw <br /> ®WILL COMMENCE ®NO CHANGE <br /> Date: <br /> ®O PERAT(ON <br /> AVERAGE ANNUAL PEAK DAILY 4 r 18 0 FACILITY SITE CAPACITY EXPECTED CLOSURE DATE: <br /> LOADING(TPY): LOADING(TPOI: x2.Q..SIZE(A): 157 acres iN YARDS: 13 894,at000 0 <br /> 111. OPERATOR OWNER OF LAND ADDRESS: TELEPHONE NUMBER: <br /> INFORMATION (Nerve): <br /> For land disposal. Forward Inc . P.O.Box 6336 Stockton CA 95206 209 466-4482 <br /> H operator Is FACILITY OPERATOR ADDRESS: <br /> different from (Name): <br /> land owner,ansch Forward, Ing . P-0-Box 6336 , Stockton, CA 95206 ( 209 ) 466-4482 <br /> lease or francNee [ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: TELEPHONE NUMBER: <br /> ■gn.ement. 1145 W. Charter Way, otgckton , CA 952Q6 - <br /> 44 <br /> I hereby acknowledge that I have read this application and the Report of Facility Information, and certify that the information given is <br /> true and accurate to the best of my knowledge and belief. In operating the solid waste facility. I agree to comply with.the.conditions <br /> of the permit and with federal, state,and local enactments. <br /> SIGNATURE (LAND W R OR AGE TI: SIGNATURE fF4CIJLrTY OPERA R AGENT): <br /> Qa <br /> TYPED NAME: Ila x TYPED NAME: <br /> r <br /> TITLE: OATE: , 1-9-94 TITLE: DATE: <br /> IV.LIST OF ATTACHMENTS ICHECK IF APPLICABLE): <br /> a REPORT OF FACILITY INFORMATION ®SWAT(AIR AND WATER) <br /> 7PERIODIC SITE REVIEW ®STORMWATER DISCHARGE PERMITS(NPOESI <br /> ®LOCAL USE/PLANNING PERMITS ®WETLANDS PERMIT <br /> 11OPERATING LIABILITY FINANCIAL MECHANISM ®PRELIMINARY CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br /> ®DEPARTMENT OF HEALTH SERVICES PERMIT ®FINAL CLOSURE/P"OSTCLOSURE MAINENANCE PLAN <br /> ®AIR QUALITY/POLLUTION CONTROL DISTRICT PERMITS ®FINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ®CERTIFIED ENVIRONMENTAL REVIEW REPORTS (CEQAI ®OTHER REGULATORY AGENCY PERMITS <br /> 11 WASTE DISCHARGE REQUIREMENTS ®OTHER <br /> �EAMIT.XlStA 21 1 <br />