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A. Facility: Page 1 CALIFORNIA ENVIRONMENTAL PROTECTION AGENCY State of California Regional Water Quality Control Board APPLICATION/REPORT OF WASTE DISCHARGE GENERAL INFORMATION FORM FOR WASTE DISCHARGE REQUIREMENTS OR NPDES PERMIT I. FACILITY INFORMATION Name: Castello Estates Subdivision Address: McArther & Linne Roads City: N/A County: San Joaquin State: CA Zip Code: N/A Contact Person: Dave Olmstead Telephone Number: 209-835-7284 Facility Owner: Name: W.D.O., INC. Owner Type (Check One) Individual 2. g Corporation Governmental 4. M Partnership 1. U 3. . Address: 23950 So. Chrisman Road 5 E Agency Other: City: Tracy State: CA Zip Code: 95376 Contact Person: Dave Olmstead Telephone Number: 209-835-7284 Federal Tax ID: Facility Operator (The agency or business, not the person): Name: See attached project report Operator Type (Check One) Individual 2. Governmental 4. Agency Other: 1. II UCorporation Address: 3. IN 111 Partnership City: State: Zip Code: 5.0 Contact Person: Telephone Number: Owner of the Land: Name: W.D.O., INC. Owner Type (Check One) 2. 2 Corporation 4. Partnership 1. El Individual 3. M Governmental Address: 23950 So. Chrisman Road Agency City: Tracy State: CA Zip Code: 95376 5.0 Other: Contact Person: Dave Olmstead Telephone Number: 209-835-7284 Address Where Legal Notice May Be Served: Address: Same as "D" above City: State: Zip Code: Contact Person: Telephone Number: Billing Address: Address: Same as "D" above City: State: Zip Code: Contact Person: / , i , i , - Telephone Number: . i L.__ ,. 'orm 20016197)