DAQ-2024-010171

DESIGN CAPACITY REPORT DATE: _________________ State of Utah
Department of Environmental Quality
__ Initial Division of Air Quality
__ Amended PO. Box 144820
Salt Lake City, UT 84114-4820
1. Landfill Name ____________________________________ Telephone: [phone]
2. Landfill Owner/Operator Name: Contact Name:
Street: Title:
City, State, Zip: Telephone:
Fax:
3. [ ] Please check if mailing address for this landfill is the same as the mailing address given above. If different mailing address
for this landfill, please complete the following:
Site Address: Name: _______________________
Street: _______________________
City, State: ___________________ Zip: ___________
4. Location information: County: 5. Year landfill began accepting waste
_________
Latitude: UTM East:
Longitude: UTM North: Year landfill closed _________
6. Total design capacity of landfill __________ [ ] Mg 7. Has a modification been made since
Estimate Code ________________ [ ] Tons May 30, 1991?
[ ] yd3
Attach permit and mao specifying capacity or calculations [ ] m3 [ ] Yes [ ] No
__________________________________________
8. Is this landfill a major source by Title V definition? [ ] Yes [ ] No

10. Name (type or print) _________________________ Title: _______________________________

Signature: ___________________________________ Date: ______________________________