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li `''–L-1'%�– =qF 16:48 T. III I TY'' I I 1 I I CT ° 1 q <br />,- _ _fid S_L^IL _ E 0t 4E_:_ 178 P. 0:3 <br />State of California - Enviro—e. hatecuon .agency Dc� ient of Toxic Substances Control <br />FACILTY NAME East Side Community Park ID N--L'NI.BER CA11111000491 <br />TE'-,VP0RAr2.Y HOUSEHOLD HAZARDOC'S W-kS-17E <br />COLLECTION FACILITY <br />PERMIT BY RUE NOTMCATION <br />K. IS THE PROPERTY ON WIECH THE TH:f- VC WILL BE HEI -D 0AiED BY <br />THE OPEK- TOR" <br />YES NO <br />u ❑ If net. a written agreement bem,een the operator :and the property owner !s requued <br />Property owner's name <br />Phone number <br />ti ATT.4CliN' 'TS <br />❑ A. The financial assurance certifications required ny title (XP, Sections <br />67450 16. <br />III DAYS ANT) HOLRS OF OPERATION <br />Show hours using a 24-hour clack. i=znmple: l pm should be shown as i 'OC <br />PI.A. l T -D DATES HOURS ALTERNATE DATL S <br />vlontaDa�/Y'ear Open Close MonthDayNcar Open <br />Oban''; % <br />WISC 8464 (9192) <br />11:30 14:30 <br />HOURS <br />