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San Joaquin County <br />-nv1ronmental Health Depa <br />1868 E Hazelton Avenu Stockton, California 95205 <br />Website: www.sjgov.org/ehd <br />Phone: (209) 468-34"0 <br />F '(209)468-3433 <br />t DIRECTOR <br />Donna Heran, REHS <br />PROGRAM COOROINA ORS <br />Robert MCCieiion, REHS <br />Jeff Carruesco, REHS, ROI <br />Kasey Foley, REHS <br />Linda Turkatte, REHS <br />Rodney Estrada, REHS Adrienne Ellsaesser, REHS <br />HAZARDOUS MATERIALS DISCLOSURE SURVEY <br />A separate survey form is required for each business name and/or address in San Joaquin County. <br />Business Name: Aero Turbine, Inc. Telephone: (209) 983-1112Business Site Address: 6800 S. Lindbergh Street Mailing Address (if different from above): _...;S;;..;:a=m=e------���-�------------­Business Owner(s) Name: Talon Holding Company Telephone: (310) 362-3312 Business Owner Address: 1800 Avenue of the Stars S TE 625 Los Angeles CA 90067Nature of Business: Ae rospace MRO Facility Fire District: Montezuma01 �Yes □ No <br />1e_Yes □ No <br />Does your business handle a hazardous material in any quantity at any one time in the year? See the definition of hazardous material on page 2 of this form. <br />Does your business generate, treat, or store a hazardous waste in any quantity? (used oil, <br />used antifreeze, waste solvent, etc.) <br />if your 11n11w®r ie "No" to both questions In Q1, please print, sign, and date the bottom of this fom, and retum to the address above. <br />02.oc_Yes □ No Does your business handle a hazardous material, or a mixture containing a hazardous <br />material, in a quantity equal to or greater than 55 gallons, 500 pounds, or 200 cubic feet at <br />any one time in the year? <br />Q3. <br />04. <br />If "Yes", how long have you handled these materials at your business? > 15 YearsIf "Yes", check any of the following conditions that apply to your business: <br />□A.The hazardous materials handled by this business are contained solely in a consumer <br />product packaged for direct distribution to and use by the general public. <br />□B.This business operates a farm for purposes of cultivating the soil, raising or harvesting an <br />agricultural or horticultural commodity. <br />•j{ Yes □ No <br />xYes □ No <br />Does your business handle an Acutely Hazardous Material? See definition on page 2. <br />Is your business within 1,000 feet of the outer boundary of a school? (Grades K-12) <br />I have read the information on this form and understand my requirements under Chapter 6.95 of the California Health and <br />Safety Code (HSC). I understand that if I own a facility or property that is used by tenants, it is my responsibility to notify the <br />tenants of the requirements which must be met prior to issuance of a Certificate of Occupancy or beginning of operations. 1 <br />declare under the penalty of perjury that the information provided on this disclosure survey is true and accurate to the best of <br />my knowledge. <br />Owner or Authorized Agent: <br />Print Name: Barry J. Renn Signature: /j�� ,._,__,__ - <br />RRubuui 1111l7l1' <br />Date: <br />Title: --� __ D_i_r_ec_t_o_r_o_f_Q...:;.....u_al_it �y_S�y:_s_te_m_s __ 1