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JUN it 19918 3 <br />�UUK.ft�.Gt e��t <br />?� Of E 414 DER Farm ! 17'710 <br />--- � Florida Department of Environmental Regulation Form <br />, <br />i ' Tbvinlowers Office Bldg. • 2600 Blair Stone Road • Wlahassee, Florida 32399-2400 EaecOve Date— <br />DER Appfimkm N� <br />'1%47f OF FlOR�04• (Filled In by DER) <br />1. Name of Applicant: <br />Solid Waste Tire Grant Application <br />INDIAN RIVER COUNTY <br />2. Address of Applicant: 1840 25TH STREET <br />VERO BEACH, FL 32960 <br />3. Federal Employer Identification Number: <br />59-6000674 <br />4. Telephone Number for Applicant: ( 407 ) 567-8000 <br />5. List of Counties Included in the Application: <br />Indian River County and Cities of: Vero Beach, Sebastian, Fellsmere. Town of Indian River <br />Shores and Town of Orchid <br />6. Contact Person (person handling program on daily basis): Sam Rohlfing, Recycling Coordinator <br />7. Address of Contact Person: Solid Waste Disposal District <br />1840 25th Street <br />Vero Beach, FL 32960 <br />8. Telephone Number of Contact Person: ( 407 ) 567-8000 EXT. 394 <br />9. Name and Title of Authorized Representative: <br />Richard N. Bird <br />Name: <br />Title: _ Chairman,-* Board of County Commissioners <br />10. Purpose for which grant money is requested. (Indicate by checkmarks): Rule 17-716.620 <br />a. Construction of waste tire processing facility <br />f. Contract for removal of waste tiresLJ� <br />Oete <br />Admin. <br />b. Operation of waste tire processing facility <br />Legal <br />g. Research to facilitate waste fire recycling <br />❑ <br />c. Contract for waste tire facility service <br />ET <br />h. Establishing waste tire collection centers <br />❑ <br />Fml Myers. FlorWa 33901-2896 <br />d. Equipment for waste tire processing facility <br />813332.2667 <br />i. Incentives for establishing private waste fire <br />❑ <br />e. Removal of waste tires <br />collecfion centers <br />11. This application is due by July 1 of each year. <br />I CERTIFY that I am familiar with the information contained in this application, and that to the best of my knowledge and belief such <br />information is true, complete and accurate. I further certify that I possess the authority to apply for this grant on behalf of this county. <br />Signature of Authorized Representative <br />Richard N. Bird, Chairman Please return form to: <br />Board of County Commissioners Department of Environmental Regulation <br />Bureau of Waste Planning and Regulation <br />Solid Waste Section <br />2600 Blair Stone Road <br />Tallahassee, Florida 32399-2400 <br />Page t of t <br />Northwest District <br />16D Goserrvnentat Carder <br />Pensacola. Fbdda 325o1-5764 <br />e•w. <br />L J <br />Northeast Distria CeMre1 Dletrrct sou"WAW 09Md <br />3426 Bine Rd. 3319 Maguire Blvd. Suite 232 4520 Oak Fe's Blvd. <br />Jacksorrviae, F mida 32207 Orlando. Florida 32803-37® Tempa. Fbnda 33310.7347 <br />on4-?M4PM 407-894.7555 813.6233681 <br />10 <br />Date <br />Indian River Co. Approved <br />Oete <br />Admin. <br />Legal <br />Budget <br />Utilitics <br />Rick D <br />Sou&mst <br />Fml Myers. FlorWa 33901-2896 <br />Suite A <br />WaM Palm Beach. FWnda 33406 <br />813332.2667 <br />407.964.9668 <br />M <br />