Laserfiche WebLink
o EPA ID NUMBER CAL000063116 Page 2 of <br /> -I� AELING ADDRESS, IF DIFFERENT: <br /> COMPANY NAME (DBA) Delta RadjolQgy Marl;cal Gro,ro Tnr` <br /> . t . <br /> STREE719 1121 W. Vine St. , Suite 15 <br /> i <br /> • r °; <br /> CITY Tnrli STATE CzA.ZIP 95240 <br /> ' COUNTRY <br /> (ody complete if 1101 USA) <br /> CONTACT PERSON Ni ra Ke = PHONE NUMBERC 209) 369 .8261 <br /> (First Name) (Lu Name) <br /> III. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: <br /> Use either one or two SIC codes (a jour digit nuniber) that best describe your company's products, services, or industrial activity. <br /> Example: 3 Phoro n shine lab <br /> P Z$'! 1r 3672 Printed circuit boards i <br /> First: 8011 Radiology Office Second: <br /> IV. PRIOR PERMIT STATUS: Check yes or no to each question: <br /> YES NO <br /> ❑ ® 1. Did you file a PBR Notice of Intent to Operate (DTSC Form 8362) in 1992 for this location? <br /> ❑ ® 2. Do you now have or have you ever held a state or federal hazardous waste facility full permit or interim <br /> r„ status for any of these treatment units? <br /> ❑ ❑ 3. Do you now have or have you ever held a state or federal full permit or interim status for any other <br /> hazardous waste activities at this location? <br /> ❑ ® 4. Have you ever held a variance issued by the Department of Toxic Substances Control for the treatment you <br /> are now notifying for at this location? <br /> ❑ ® 5. Has this location ever been inspected by the state or any local agency as a hazardous waste geaerator? <br /> V. PRIOR ENFORCEl11ENT HISTORY: Not required from gen asors only norIrying as oandirfonally=a W, <br /> YES NO <br /> ❑ ❑ Within the last three years, has this facility been the subject of any convictions,judgments, settlements• or final <br /> orders resulting from an action by any local, state, or federal environmental, hazardous waste, or public health <br /> enforcement agency? <br /> (For the purposes of this form, a notice of violation does not constitute an order and need not be reported uclesa <br /> it was not eorrocted and became a final order.) <br /> ❑ If you answered Yes,check this box and attach a listing of convictions,judgments, settlements, or orders and a eoT <br /> of the cover shat from each document. (See the Instructions for more information) <br /> DTSC 1772 (1193) p, -, , <br />