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{ <br /> State of California—California Environmental Prot n Agency Department of Toxic Substances Control <br /> TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br /> COLLECTION FACILITY <br /> PERMIT BY RULE NOTIFICATION <br /> For use by public agencies operating a Temporary Household Hazardous Waste Collection Facility(THHWCF)under Permit By Rule.Each location requires a <br /> separate form. <br /> ✓Q INITIAL NOTIFICATION ❑REVISED NOTIFICATION Put an asterisk in the left margin next to the revised <br /> information <br /> I. GENERAL INFORMATION <br /> A. FACILITY ID NUMBER CAH 111000857 <br /> B. FACILITY NAME Tracy Municipal Airport <br /> C. FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY LOCATION <br /> ADDRESS 5749 South Tracy Boulevard <br /> CITY Tracy STATE CA ZIP 95377 <br /> COUNTY San Joaquin <br /> D. OPERATOR(PUBLIC AGENCY) <br /> AGENCY NAME County of San Joaquin <br /> Department of Public Works <br /> MAILING ADDRESS P.O. Box 1810, 1810 East Hazelton Avenue <br /> CITY Stockton STATE CA ZIP 95201 <br /> COUNTY San Joaquin <br /> E. OPERATOR/AGENCY CONTACT PERSON INFORMATION <br /> CONTACT PERSON Andrews Kimbra <br /> (LAST NAME) (FIRST NAME) <br /> PHONE NUMBER (209)468-3066 <br /> DISC 8464(revised 10/07) PAGE 1 OF 4 <br />