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TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br /> COLLECTION FACILITY <br /> PERMIT BY RULE NOTIFICATION <br /> F. CONTRACTOR INFORMATION (if applicable) <br /> NAME 21st Century Envl Mqmt of CA, LP <br /> MAILING ADDRESS 11855 White Rock Road <br /> CITY Rancho Ccp STATE CA ZIP 95742 <br /> G . CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br /> CONTACT PERSON Zuniqa Carmen <br /> (LAST NAME) (FIRST NAME) <br /> PHONE NUMBER ( 909 ) 971 -7036 <br /> H. ACCEPTANCE OF CESQG WASTES <br /> YES NO <br /> 0 ❑ Will your facility accept wastes from conditionally exempt small quantity generators? <br /> I. THE FOLLOWING LOCAL AUTHORITIES HAVE BEEN NOTIFIED OF THE INTENDED <br /> OPERATION OF THE THHWCF : <br /> Environmental Management <br /> 0 Fire Department <br /> 0 Law Enforcement <br /> 0 Traffic <br /> 0 Air Quality <br /> Fi <br /> J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION OF THE <br /> THHWCF : <br /> DTSC 8464 (revised 10/07) PAGE 2 or 4 <br />