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IF"YES",PLEASE ANSWER THE FOLLOWING: <br /> WHO WILL PREPARE T ? <br /> APPROXIMATE DATE OF COMPLETION: <br /> TYPE OF BUSINESS OPERATING FACILITY: <br /> F-JSOLE PROPRIETORSHIP ®PARTNERSHIP CORPORATION GOVERNMENT AGENCY <br /> V.OPERATOR <br /> INFORMATION OWNER OF LAND ADDRESS: TELEPHONE#: SSN OR TAX ID# <br /> For land disposal if (Name):Fonvard Inc. 9999 S.Austin Road,Manteca,CA (209)982-4298 941544481 <br /> operator is different 95336 <br /> from <br /> land owner, <br /> attach lease or FACILITY OPERATOR ADDRESS: TELEPHONE#: SSN OR TAX ID# <br /> franchise agreement. <br /> (Name):Forward Inc. 9999 S.Austin Road,Manteca,CA (209)982-4298 941544481 - <br /> 95336 <br /> ADDRESS WHERE LEGAL NOTICE MAY BE SERVED: <br /> 9999 S.Austin Road,Manteca,CA 95336 <br /> 1 hereby acknowledge that I have read Is application and the Report of Facility Information,If applicable,JTD or ROWD and certify that the <br /> 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 <br /> conditions of the permit and with federal,state,and local enactment's. <br /> SIGNAT E ND OWR OR AGENT): SIGNATURE(FACILITY OPERATOR OR AGENT): <br /> TYPED NAM : TYPED NAME: <br /> Kevin asso <br /> TITLE: DATE: TITLE: DATE: <br /> General Mana er <br /> VI.LIST OF ATTACHMENTS(CHECK IF APPLICABLE): <br /> ®REPORT OF FACILITY INFORMATION ®OPERATING LIABILITY FINANCIAL MECHANISM <br /> ®REPORT OF WASTE DISCHARGE OPRELIMINARY CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br /> x JTD(RDSI/ROWD) FINAL CLOSURE/POSTCLOSURE MAINTENANCE PLAN <br /> CONTRACT AGREEMENTS FINANCIAL RESPONSIBILITY DOCUMENTATION <br /> ®DEPARTMENT OF HEALTH SERVICES PERMIT ®OTHER REGULATORY AGENCY PERMITS <br /> ®LOCAL USE/PLANNING PERMITS ā¯‘OTHER: <br /> ®CERTIFIED ENVIRONMENTAL REVIEW REPORTS(CEQA) <br /> INFORMATION ON THE STATUS OF THE APPLICANTS COMPLIANCE WITH CEQA REQUIREMENTS REGARDING <br /> THE PROPOSED PROJECT. <br /> ®EVIDENCE THAT THERE HAS BEEN COMPLIANCE WITH CEQA PRC,DIVISION 13,2100 et.sec <br /> version 4-6/96 <br />