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Department of Toxic Substances Control <br /> State of California — California Environmental Protection Agency <br /> Octan Apt3ti8t7G� �(onthlY eport For <br /> please send this document on a monthly basis to QTSC by mailing to . <br /> Attn : Consumer Products Section <br /> Department of Toxic Substances Control <br /> office of pollution Prevention and Green Technology <br /> 1001 " 1" Street, 11 th Floor <br /> P . O . Sox 806 <br /> ! Sacramento , California 95812 -0808 <br /> Month : O &IO & ` Year : 7 Ll &A ;I ! Aj <br /> Name of scrap recycling facility : S Ifl� <br /> Facility address ' <br /> Name of CARO t4 <br /> Total number of" orphan " appliances received this month (as indicated by use of OTSC <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 /> : Trash compactors :fW <br /> Dryers <br /> Ovens . <br /> Other (please specify) : <br /> The names and addresses of each person who transported , delivered , or sold "orphan" <br /> facility is included on the following additional pages . <br /> appliances to this scrap recycling <br /> This information has also been supmitted to my CUPA < <br /> Sincerely , <br /> Universal Service Recycling, Inc . <br /> pawl Bischofberger • 0 ' " " ' <br /> Name ,v , Environmental Health & Safety <br /> 209 . 944 . 9555 <br /> r'AX : 209 . 944 . 5552 <br /> CELL: 209 . 855 • 1715 <br /> Contact Informi 3204 South El Dorado Street, Stockton , CA 95206 <br /> E-mail: Pbischofberget@usrscrap.com page l of 1 <br /> www.usrscrap.com <br /> VTSC Form 1468 till ; <br />