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use � • <br /> y P.O.BOX 1810-1810 E.HAZELTON AVENUE <br /> STOCKTON,CALIFORNIA 95201 <br /> .i (209)46FAX(209)468-2999 <br /> www.sww.sjgjgov.org/pubworks <br /> OVorkiug f"YOU RECEIVED <br /> MICHAEL SELLING <br /> DEPUTY DIRECTOR DEC 2 9 2014 <br /> FRITZ BUCHMAN <br /> DEPUTY DIRECTOR <br /> JIM STONE ENVIRONMENTAL HEXTH <br /> DEPUTY DIRECTOR PERMITISERVICES <br /> ROGERJANES <br /> BUSINESS ADMINISTRATOR <br /> TO: San Joaquin County Environmental Health DATE: December 29, 2014 <br /> Department <br /> 1868 E. Hazelton Avenue SUBJECT: HOUSEHOLD HAZARDOUS <br /> Stockton, California 95202 WASTE COLLECTION EVENT PERMIT BY <br /> RULE NOTIFICATION <br /> Attn: Kasey Foley, CUPA Program <br /> TRANSMITTED HEREWITH: X <br /> UNDER SEPARATE COVER: <br /> No. of Copies Description <br /> 1 Temporary HHW Collection Facility Permit By Rule Notification (DTSC 8464) <br /> 1 Letter of agreement from property owner <br /> Remarks: Enclosed is the Temporary Household Hazardous Waste Collection Facility Permit By Rule <br /> Notification and letter for an upcoming HHW Event scheduled for Saturday, February 21, 2015, at the <br /> Escalon Community Center. Any CESQG appointments, if requested, will be scheduled for Friday, <br /> February 20th after set-up. <br /> As part of the documentation requirements, we must have on file proof of receipt of this PBR notification <br /> by our COPA. To help us fulfill this requirement, please complete the lines below to acknowledge receipt <br /> of this PBR notification. Please send this signed document back to Elisa Moberly emoberly@sjgov.org or <br /> fax to 468-3078. <br /> PBR notification received by CUPA on, <br /> C �'_1-ou'94—, t4'1� <br /> AS ignature Printed Name <br /> If you have any questions, please contact me at(209) 468-3066. <br /> ELISA MOBE L <br /> Environmental Operation Division <br /> San Joaquin Co. Public Works Dept., Solid Waste Div. <br /> EM:sc <br /> P:\HHW\HHW Facilities\Sate[lite events\Satellite-Escalon\2015 Escalon HHW Event\Working File\Escalon 2015 CUPA PBR <br /> Transmittal.docx <br /> c: Elena Manzo, CUPA Program <br /> Enclosures <br /> HA 30010C <br />