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16: 47 T. r-:0l_P17`r' S iL I D !,IPSTE 209 4687-1078 F F. C17 <br />state or cauernin - Environ— h vtKtion Agency Dr' lent of Toxic Subatence" Control <br />FACULTY NAME East Side Community Park :D NIIMBER CAHI II000491 <br />TEIvIPOR.ARY HOUSEHOLD H AZ_RDOiL S WASTE <br />COLLECTION FACUAT'Y <br />PERMIT BY RULE NOTLFICATION <br />F CONTRACTOR LNFORIMATION (if appiica ie.! <br />Name Burlington Environmental dba Philip Environmental <br />Mailing-ddress 301A W. Channel Rd. <br />City Benicia CA Lip Code 94510 <br />G (.;O-NTR-CTOR CONTACT PERSON (if applicable) <br />Contact Hoskins, Cliff <br />Phone Number (707)747-7700 <br />H kCCE.PT ANICE OF COWMERCLA1 W AS` T S <br />YES v0 <br />C Cx7 W''ill -your facility accept waste from small qua ritat coumlercial Source <br />generators' <br />I THE FOLLOW NG LOCM. AUTHORITIES KAVVE BEF.114 \0TiFI D O) THE <br />INIT.N-DED OPER-kfIONOF THE THHW'CF <br />i-rwironmen13 Management <br />23 Fire Department <br />U uaw Enforcement <br />Lx I-raffic <br />LXl .-r Qual.tty <br />THE FOLLOWr'LNG LOCM.. PF_RN ITI'S HLkvT E3LE�i OB I AI�EU FOR <br />()PLR.vTION OF IHE THHWCF <br />pTSC 8464 (9192) Page 2 of 4 <br />