SNW PERMIT APPLICATION FORM TO OPERATE OR MODIFY A SOLID WASTE MANAGEMENT FACILITY Southern "Mila HARh District I ForSNHD Use Only I CONTROUPERMIT NUMBER: o New Permit Application o Major Modification o Minbr Modification o Variance o Revision o Temporary 1. Type Of Solid Waste Management Facility 0 Class I Disposal Site 0 Class II Disposal Site o Class III Disposal Site 0 Compost Plant 0 Construction and Demolition o Materials Recovery Facility Waste Short-Term Storage Facility 0 Public Waste Storage Bin Facility I23J Recycling Center o Salvage Yard 0 Transfer Station 0 Waste Tire Management Facility 2. Name of Facility American Eagle Ready Mix, LLC Fictitious Firm Name (dba) Not Applicable Street Address City, State, Zip Facility Address 14330 Garza St Las Vegas, NV 89054 Telephone Number Emergency Telephone Number (702)733-2453 (702)355-3811 - Galen Stockton Mailing Address Street Address/PO Box City, State, Zip 120 W Delhi Ave North Las Vegas, NV 89032 Parcel Number (s) 191-19-301-005 & -006 Jurisdiction Zoning Classification (e.g. M-1, M-2, etc) CC Unincorporated M-1 Name Edward Stockton Contact Information Phone Number Email Address (702)355-3811 [email protected]3. Name of Facility/Business ie Corporation, Sole Proprietorship, or Last Name, First 1ame & Middle Initial Owner (Legal) American Eagle Ready Mix, LLC , Mailing Address Street Address City, State, Zip 120 W Delhi Ave North Las Vegas, NV 89032 Telephone Number(s) Telephone Number Fax Number (702)733-2453 (702)733-3011 4. Name of Facility/Business ie Corporation, Sole Proprietorship, or Last Name, First Name & Middle Initial Operator ~merican Eagle Ready Mix, LLC Address Street Address City, State, Zip 120 W Delhi Ave North Las Vegas, NV 89032 Telephone Number(s) Telephone Number Emergency Telephone Number (702)733-2453 (702)355-3811 - Galen Stockton 5. Design Parameters Inside/Outside Area (Sq. Ft) storage Capacity (cubic yards) Processing Capacity 1710,000 sq ft 250,000 cubic yards (i.e. cubic yds/day; tons/day) 19,100 cubic yards/day 6. Solid Waste Types Proposed for Acceptance Complete Attached SOLID WASTE CATEG<pRIES AND TYPES TO BE PROCESSED form ! Permit Application Form to Operate a Solid Was~e Management Facility February 2013 i Page 1 of2
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SNW PERMIT APPLICATION FORM TO OPERATE OR MODIFYA SOLID WASTE MANAGEMENT FACILITY
Southern "Mila HARh DistrictI
ForSNHD Use OnlyI
CONTROUPERMIT NUMBER:
o New Permit Application oMajor Modification oMinbr ModificationoVariance o Revision oTemporary
1. Type Of Solid Waste Management Facility
0 Class IDisposal Site 0 Class II Disposal Site o Class III Disposal Site
0 Compost Plant 0 Construction and Demolition o Materials Recovery FacilityWaste Short-Term Storage Facility
0 Public Waste Storage Bin Facility I23J Recycling Center o Salvage Yard
0 Transfer Station 0 Waste Tire Management Facility
2. Name of Facility American Eagle Ready Mix, LLC
Fictitious Firm Name (dba) Not Applicable
Street Address City, State, Zip
Facility Address14330 Garza St Las Vegas, NV 89054Telephone Number Emergency Telephone Number(702)733-2453 (702)355-3811 - Galen Stockton
Mailing AddressStreet Address/PO Box City, State, Zip120 W Delhi Ave North Las Vegas, NV 89032Parcel Number (s) 191-19-301-005 & -006
6. Solid Waste Types Proposed for AcceptanceComplete Attached SOLID WASTE CATEG<pRIES AND TYPES TO BE PROCESSED form
!Permit Application Form to Operate a Solid Was~e Management FacilityFebruary 2013 i Page 1 of2
7. Operations Hours of Operations Days of Operation6:00 am - 3:00 pm Monday-Friday (Saturday if needed)
Open to the Public Hours of Operations Days of OperationNot Open to the Public Not Open to the Public
This application form and supporting documents, as required by the current version of the Application Guide for thisfacility type, are hereby submitted to SNHD to apply for a permit to operate or modify a solid waste management facility.We understand that receipt of this application does not constitute an approval to operate or modify the facility. Weunderstand that this application must be approved by SNHD and a permit issued before the operation or modification ofthe facility. We certify that the Report of Design supports the Report of Operating Plan. We certify that, to the best of ourknowledge, the information contained above and in the supporting documents is complete and accurate and complieswith the requirements specified in the current version of the Application Guide for this facility type and the Solid WasteManagement Authority Regulations for this type of Solid Waste Management Facility8. Certifications A J I
~~ Signature of Applicant Agent~~~
.. G\NE£A
~
(facility owner or operator)
~W1'v ~'"
Printed name of Applicant Agent &/.)/~A ffr;-~/th-. 0 JAIMEEM. 0 t (facility owner or operator)• (f) \YOSHj~i\fA -n~ 'V-U.if· ~ Title of Applicant Agent
Pn~s~Jt'.•.TO~~VjL..;.;_ ,J,.!i) (facilitv owner or ooerator)~ 4' -~x-:-<.,~-~~
~>~~'" ~;; c» Telephone Number 702- 3!r-3BI(~~4IWt~PE stamp, expiration date, Date of Signing 1\ -4-1 L\signature and sianature date
9. Receipt of Application (for SNHD use only)
Signature of SNHD staff
Printed name of SNHD staff
Title of SNHD staff
SNHD date stampDate of signing
10. Name of Property Owner ie Corpo'!!.tio:;,Sole ~ArshiP' p;Last NamlYLirst Nahi & M~tialAAJII--':r J(·UIl.I '.I::r:: --"'" / if At t; ~
Telephone Number(s) (702)39.4.•• ii ~O"" rlK;:""7 ../
Address Street Addressi'W W ~ ~rt" ~' State Zip fJiAnAn • ~& '~
••• IVV S Vegas, NVi9'Hit
11. Name of ConsultantLast Name IFirst Name Middle InitialWalker Julie
Company GWEConsulting Inc
Telephone Number(s) (702)405-6241 I CeJlPhone Number(702)370-6890