Laserfiche WebLink
State of California—California Environmental Protection Agency Department of Toxic Substances Control <br /> Orphan A liance Monthly a ort For <br /> E t E _"D <br /> Please send this document on a monthly basis to DTSC by mailing to: <br /> Attn: Consumer Products Section WR 17 2017 <br /> Department of Toxic Substances Control <br /> Office of Pollution Prevention and Green Technology <br /> 1001 "I" Street, 11th Floor ENVIRONMENTAL. HEALTH <br /> P.O. Box 806 DEPARTMENT <br /> Sacramento, California 95812-0806 <br /> Month: ,�,�3a�vP� Year: A)y ikFaPc <br /> eo <br /> Name of scrap recycling facility: (1 <br /> .J k <br /> Facility address: `�-`6 Al' �z <br /> �QC <br /> Name of CAR: JSR CAR # i;.7, <br /> Total number of"orphan" appliances received this month (as indicated by use of DTSC <br /> Form 1459) received: <br /> This information is not required, but is appreciated: <br /> Space Heaters: Stoves: <br /> Refrigerators: Boilers: <br /> Freezers: Furnaces: <br /> Microwaves: - Water Heaters: <br /> Washers: Air conditioners: <br /> Dryers: Trash compactors: <br /> Ovens: <br /> Other (please specify): <br /> The names and addresses of each person who transported, delivered, or sold "orphan" <br /> appliances to this scrap recycling facility is included on the following additional pages. <br /> This information has also been submitted to my CUPA. <br /> Sincerely, ............. _ <br /> Universal Service Recycling, Inc. <br /> ......•••• ......•••• Paul Bischofberger <br /> it I IV <br /> Nameiz] EEnvironmcntal Hcalth&Safcty <br /> 209•944•9555 <br /> FAX:209•944.5552 <br /> ............................... CELL:209.855. 1715 <br /> Contact Information 3200 South El Dorado Street,Stockton,CA 95206 <br /> E-mail: Pbischofberger@usrscrap.com <br /> DTSC Form 1468(1116109) www.usrscrap.com Pape 1 of 1 <br />