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0 1/1,0/ 86 1 l't 1 J.& v tAn 8 8 r 1 4 1 1 I O U <br />State urCulirorni■ - Fnvironmental . ..ection Agency <br />Department _ ioxlc Substances Control <br />FACILTY NAME Escaion Community Center ID NUMBER CAHI 11000284 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />K. IS THE PROPERTY ON WHICH THE THHWCF WILL BE HELD OWNED BY <br />THE OPERATOR? <br />YES NO <br />0 ❑ If not, a written agreement between the operator and the property owner is required. <br />Property owner's name City of Escalon <br />Phone number (209) 838-3556 <br />II. ATTACHMENTS <br />❑ A. The financial assurance certifications regttired by title 22, CCR, Sections <br />67450.16. <br />III. DAYS AND HOURS OF OPERATION <br />Show hours using a 24-hour clock. Example. Ipm should be shown as 1300 <br />PLANNED DATES HOURS ALTERNATE DATES HOURS <br />Month/lay/Year Open Close Month/DayNear Open Close <br />08/10/96 12:30 15:30 <br />DTSC 8464 (9192) Page 3 of 4 <br />