Laserfiche WebLink
OT/29/96 MON 15:36 FAX 707 747 7705 PHILIP ENVIROMENTAL 0 002 <br />Stair of California - knvironmental Protection Agency Deportment of Toxic Substances Control <br />For Official Use Only <br />DTSC Regional Officc <br />TEMPORARY HOUSEHOLD HA7AKDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />For use by agencies operating a Temporary Household Hazardous Waste Collection Facility (THHWCF) <br />under Permit By Rule. Each location requires a separate form. <br />M INITIAL NOTIFICATION ❑ REVISED NOTIFICATION Put an acterik <br />in the left margin next to the revised <br />information. <br />I. GENERAL fINTFORINUkTION <br />A. FACILITY ID NUMBER CAH111000595 <br />B. FACILITY NAME Payless Food Mart Parking Lot <br />C. FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY LOCATION <br />Address 18980 North Highway 88 <br />City Lockford, CA Zip Code 95236 <br />County San Joaquin <br />D. OPERATOR (PUBLIC AGENCY) <br />Agency naive County of San Joaquin Dept. of Public Works <br />Mailing Address 1810 East Hazelton <br />City Stockton CA Zip Code 95201 <br />County San Joaquin <br />E. OPERATOR/AGENCY CONTACT PERSON INFORMATION <br />Contact Person Hudson, Alison <br />Phone Number (209) 468-3066 <br />DTSC 9464 (9192) Page l of 4 <br />