Form CalRecycle92 "Standardized Permit Application" - California

What Is Form CalRecycle92?

This is a legal form that was released by the California Department of Resources Recycling and Recovery - a government authority operating within California. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on October 1, 2016;
  • The latest edition provided by the California Department of Resources Recycling and Recovery;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a fillable version of Form CalRecycle92 by clicking the link below or browse more documents and templates provided by the California Department of Resources Recycling and Recovery.

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Download Form CalRecycle92 "Standardized Permit Application" - California

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State of California • Department of Resources Recycling and Recovery (CalRecycle)
Standardized Permit Application
See instructions on back
CalRecycle 92 (Revised 10/16)
Facility Name:
Facility phone number:
(
)
Facility Address (include street, P.O. box, city, state, ZIP code):
Facility Operator's Name:
Operator's phone number:
(
)
Operator's Address (include street, P.O. box, city, state, ZIP code):
Land Owner's Name (if different from operator):
Land Owner's phone number:
(
)
Land Owner's Address (include street, P.O. box, city, state, ZIP code):
Facility Information
California Code of Regulations section number authorizing eligibility:
Type of waste material(s) handled (please be specific):
Volume of waste material(s) handled.
Site Capacity:
Cubic yards Daily peak loading:
|
Cubic yards Annual loading:
|
Cubic yards
Days and hours of operation:
Facility size:
acres Operating area size:
|
acres
Incoming waste material (number of vehicles per day):
Outgoing waste material (number of vehicles per day):
One of the following statements must be checked:
Issuance of the permit will not prevent or substantially impair achievement of the diversion goals of the jurisdiction from
which it received solid waste; the facility is identified and described in or conforms with the county solid management
waste plan, or otherwise complies with Public Resources Code 50000; The facility is consistent with the city or county
general plan and is compatible with surrounding land uses, or otherwise complies with Public Resources Code 50000.1.
The facility is identified in either the countywide siting element, the nondisposal facility element, or in the source
reduction and recycling element for the jurisdictions in which it is located; or, that the facility is not required to be
identified in any of these elements pursuant to section 50001 of the public resources code.
This application must be accompanied by a:
Report of facility information,
Site plan,
Location map, and either
Evidence of compliance with CEQA, or
Information on the status of CEQA
Certification
I hereby acknowledge that I have read this application, and certify under penalty of perjury that the information provided is
true and accurate. In operating the facility, I agree to comply with the conditions of the permit, and with federal, state and
local requirements and enactments.
Land owner's signature:
Date signed:
Operator's signature:
Date signed:
Enforcement Agency Name and Address:
For Enforcement Agency Use Only
Date Received:
Date Approved:
Date Rejected:
Filing Fee:
SWIS #:
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State of California • Department of Resources Recycling and Recovery (CalRecycle)
Standardized Permit Application
See instructions on back
CalRecycle 92 (Revised 10/16)
Facility Name:
Facility phone number:
(
)
Facility Address (include street, P.O. box, city, state, ZIP code):
Facility Operator's Name:
Operator's phone number:
(
)
Operator's Address (include street, P.O. box, city, state, ZIP code):
Land Owner's Name (if different from operator):
Land Owner's phone number:
(
)
Land Owner's Address (include street, P.O. box, city, state, ZIP code):
Facility Information
California Code of Regulations section number authorizing eligibility:
Type of waste material(s) handled (please be specific):
Volume of waste material(s) handled.
Site Capacity:
Cubic yards Daily peak loading:
|
Cubic yards Annual loading:
|
Cubic yards
Days and hours of operation:
Facility size:
acres Operating area size:
|
acres
Incoming waste material (number of vehicles per day):
Outgoing waste material (number of vehicles per day):
One of the following statements must be checked:
Issuance of the permit will not prevent or substantially impair achievement of the diversion goals of the jurisdiction from
which it received solid waste; the facility is identified and described in or conforms with the county solid management
waste plan, or otherwise complies with Public Resources Code 50000; The facility is consistent with the city or county
general plan and is compatible with surrounding land uses, or otherwise complies with Public Resources Code 50000.1.
The facility is identified in either the countywide siting element, the nondisposal facility element, or in the source
reduction and recycling element for the jurisdictions in which it is located; or, that the facility is not required to be
identified in any of these elements pursuant to section 50001 of the public resources code.
This application must be accompanied by a:
Report of facility information,
Site plan,
Location map, and either
Evidence of compliance with CEQA, or
Information on the status of CEQA
Certification
I hereby acknowledge that I have read this application, and certify under penalty of perjury that the information provided is
true and accurate. In operating the facility, I agree to comply with the conditions of the permit, and with federal, state and
local requirements and enactments.
Land owner's signature:
Date signed:
Operator's signature:
Date signed:
Enforcement Agency Name and Address:
For Enforcement Agency Use Only
Date Received:
Date Approved:
Date Rejected:
Filing Fee:
SWIS #:
Instructions for Completing Standardized Application:
Fill out this application form completely and accurately in duplicate. After the Enforcement Agency (EA) has reviewed the
application, the EA will determine whether the application meets the requirements of section 18105.l. If the EA finds the
application is complete and correct, it shall be accepted for filing. If the application is not found to be complete and correct it
will be returned. For additional information on the procedure used for processing this application refer to Title 14 of the
California Code of Regulations, Section 18105.2 et.seg..
Facility Name: The legal name of the facility.
Facility Address/Location: The address of the facility and a description of the location if different.
Facility Operator/Land Owner: Provide both the mailing address and the location/address where process may be
served.
Section Authorizing Eligibility: You must determine the appropriate Section of the Regulations that authorize
eligibility. After determining the appropriate section list it on the application.
Type of Waste Material(s) Handled: Indicate the materials handled at the facility.
Site Capacity: Total capacity of material that can be stored at this site.
Daily Peak Loading: Is the largest project projected waste/material quantity to be received by an operation on any
day of operation.
Annual Loading: Is the maximum amount of waste/material to be handled by an operation annually.
Traffic: State the maximum number of vehicles that will enter and haul incoming material or remove compost on a
daily basis.
The operator is required to supply conformance finding information. Whichever of the two sections is appropriate to your
operation must be checked. To make the determination you can contact the Enforcement Agency, Local Task Force, or other
solid waste planning agency in your city or county.
The application must include a site map and a location map. The site map should include, but not be limited to, operations
areas and their relationships to property boundaries, adjacent land uses, proposed drainage systems, any excavation areas,
and any other portions of the site dedicated to a specific use. The location map should show the general location of the
operation at a scale size minimally equivalent to 1:24000 USGS topographical quadrangle.
A Report of Facility Information (RFI) must be included with this application. The RFI must contain all of the information
required by the applicable section(s) of Article 3.2, Chapter 5, of 14CCR.
The application must include one of the following: (1) Evidence that there has been compliance with the California
Environmental Quality Act, or (2) Information on the status of the application's compliance with the California Environmental
Quality Act regarding this facility. Once there has been compliance with the California Environmental Act, evidence shall be
submitted to the enforcement agency.
This application must be signed, under penalty of perjury, by both the land owner and the operator.
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