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03/04/97 ONSITE HAZARDOUS WASTE TREATMENT Page: 1 <br /> NOTIFICATION RENEWAL FORM CAD099952996 <br /> I. NOTIFICATION CATEGORIES REGION: 1 <br /> Number of units and attached unit specific notifications: <br /> A. 0 - Conditionally Exempt-Small Quantity Treatment <br /> B. 0 - Conditionally Exempt-Specified Wastestream <br /> C. 0 - Conditionally Authorized <br /> D. 1 - Permit By Rule <br /> E. 0 - Commercial Laundry <br /> F. 0 - Conditionally Exempt - Limited <br /> 6i_1mE- Total Number of Units <br /> II. GENERATOR IDENTIFICATION <br /> EPA ID NUMBER CAD099952996 BOE NUMBER HAHQ36028959 <br /> ------------ ------------ <br /> COMPANY NAME (DBA) HOLZ RUBBER CO INC <br /> ---------------------------------------- <br /> PHYSICAL LOCATION 1129 S SACRAMENTO ST <br /> ---------------------------------------- <br /> ---------------------------------------- <br /> CITY/STATE/ZIP LODI CA 95240 <br /> ---------------------------------------- <br /> COUNTY SAN JOAQUIN <br /> --------------- <br /> CONTACT PERSON TED COOPER 209/368-7171 ext. <br /> --------------- --------------- --------------------- <br /> (First Name) (Last Name) (Phone #) <br /> Mailing Address <br /> COMPANY NAME (DBA) HOLZ RUBBER CO INC <br /> ---------------------------------------- <br /> STREET PO BOX 241002 <br /> ---------------------------------------- <br /> ---------------------------------------- <br /> CITY/STATE/ZIP LODI CA 95241 <br /> ---------------------------------------- <br /> COUNTRY (if other than USA) <br /> -------------------- <br /> CONTACT PERSON TED COOPER 209/368-7171 ext. <br /> --------------- --------------- --------------------- <br /> (First Name) (Last Name) (Phone #) <br />