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STATE OF CALIFORNIA <br /> CALIFORNIA INTEGRATED WASTE MANAGEMENT BOARD <br /> REGIONAL WATER QUALITY CONTROL BOARD <br /> APPLICATION FOR SOLID WASTE FACILITY PERMIT TE DISCHARGE REQUIREMENTS <br /> CIWMB E-1-77(Rev.8-04) <br /> NOTE:This form has been developed for multiple uses. It is the transmittal sheet for documents required to be submitted to the appropriate agency. <br /> Please refer to the attached instructions for definitions of terms and for completing this application form in a complete and correct manner. <br /> FOR OFFICIAL USE ONLY <br /> SWIS NUMBER: FILING FEE: RECEIPT NUMBER: DATE RECEIVED: <br /> 3°I-AA - 06.0 MAY 22 2014 <br /> DATE ACCEPTED: DATE REJECTED: ACCEPTANCE DATE OF <br /> JUN 2 0 2014 INCOMPLETE APPLICATION: <br /> L_ DATE DUE: <br /> Part 1.GENERAL INFORMATION <br /> A.ENFORCEMENT AGENCY: B.COUNTY: <br /> San Joaquin County,Environmental Health Department San Joaquin <br /> C.TYPE OF APPLICATION(Check one box only): <br /> 0 1. NEW SWFP and/or WDRS 1:14.PERMIT REVIEW <br /> O2. REVISION OF SWFP and/or WDRS ®5.AMENDMENT OF APPLICATION <br /> ❑3. EXEMPTION and/or WAIVER ®6.RFI/ROWD/JTD AMENDMENTS <br /> Part 2. FACILITY DESCRIPTION <br /> A. NAME OF FACILITY: Forward Resource Recovery Facility <br /> B. LOCATION OF FACILITY: <br /> 1. PHYSICAL ADDRESS OR LOCATION AND ZIP CODE: 9999 South Austin Road,Manteca,California 95336 <br /> 2. LATITUDE AND LONGITUDE: Latitude=37.87167 Longitude=-121.1848 <br /> 3.LEGAL DESCRIPTION OF PERMITTED BOUNDARY BY SECTION,TOWNSHIP,RANGE,BASE,AND MERIDIAN,IF SURVEYED: Section 3 of Township 1 S,Range 7E,Mount Diablo <br /> Baseline and Meridian(MDB&M). Assessor Parcel No.201-060-03. <br /> C.TYPE OF ACTIVITY:(Check applicable boxes): <br /> F-11.DISPOSAL r73.TRANSFORMATION E15.OTHER(describe): <br /> a. TYPE: <br /> E✓ 2.COMPOSTING 04.TRANSFER/PROCESSING FACILITY <br /> a. TYPE:Any decomposable organic [ ] CHECK HERE IF RECYCLABLE MATERIALS ARE RECOVERED PRIOR TO TRANSFER/PROCESSING. <br /> material described in RCSI Section 1.3. <br /> D.CONFORMANCE FINDING INFORMATION(CIWMP): <br /> ❑✓ 1.FACILITY IS IDENTIFIED IN(Check one): <br /> ®SITING ELEMENT DATE OF DOCUMENT PAGE# <br /> ❑✓ NONDISPOSAL FACILITY ELEMENT DATE OF DOCUMENT:March 1995 PAGE# <br /> ®2.FACILITY IS NOT REQUIRED TO BE IDENTIFIED IN SITING ELEMENT OR NONDISPOSAL FACILITY ELEMENT <br /> E.TYPE OF PERMITTED WASTES TO BE RECEIVED:(Check applicable boxes): <br /> ❑✓ 1.AGRICULTURAL F-716.CONSTRUCTION/DEMOLITION [D 11.LIQUIDS <br /> ❑2.ASBESTOS ❑Friable ❑Non-friable F77.CONTAMINATED SOILS [Z]12.MIXED/MUNICIPAL SOLID WASTE <br /> ❑✓ 3.ASH 718.DEAD ANIMALS [E]13.SEWAGE SLUDGE(Biosolids) <br /> ❑4.AUTO SHREDDER F-719.INDUSTRIAL ✓ 14.TIRES <br /> F✓ 10.INERT 15.OTHER(describe):Food waste(including cannery rinsate) <br /> MS.COMPOSTABLE MATERIAL(describe):green material(mixed with food waste),wood waste food waste food Processing residue manure <br /> Page 1 <br />