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Sam-f C/ml. County Date Received I I. GENERAL INFORMATION d bO Operation Name 3033 DMM Address Phone C Fax Z O 0 Cn/7 State Zip G4 Zip 1 uLR C8 481344 8 4241- 3 cZ Qmnm /m. s2 f0m ac SQ rd-rx CW7 8 970 l3 IZ ax 4Z10 N. Qbdvfm Land Owner s 47 - My 1-12 FSWW II. OPERATION INFiJRMAT oN 17 S n Authorizing Eligibility state Section 4 f 14 ccR Division 7 Chapter 3 or 3. State of Califomia CIWMB 169 Rev 4104 Califomia Integrated Waste Management Board ENFORCEMENT AGENCY NOTIFICATION Enforcement...
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ciwmb 169 rev 4104 is a form used for reporting certain waste management activities.
Businesses involved in waste management activities are required to file ciwmb 169 rev 4104.
To fill out ciwmb 169 rev 4104, the business must provide detailed information about their waste management practices.
The purpose of ciwmb 169 rev 4104 is to monitor and regulate waste management activities to ensure compliance with environmental regulations.
Information such as types of waste generated, disposal methods used, and quantities of waste must be reported on ciwmb 169 rev 4104.
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