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State of California -Environmental Protection A, <br />Department of Toxic Substance Control <br />FOR OFFICIAL USE ONLY ; <br />DTSC REGIONAL OFFICE i <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />For use by agencies operating a Temporary Household Hazardous Waste Collection Facility (THHWCF) under Permit By Rule. Each <br />location requires a separate form. <br />❑X INITIAL NOTIFICATION REVISED NOTIFICATION Put an <br />asterisk in the left margin next to the <br />revised information. <br />I. GENERAL INFORMATION <br />A. FACILITY ID NUMBER CAH 11100598 / <br />B. FACILITY NAME New Hope School <br />C . FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 26657 North Sacramento Blvd. <br />CITY <br />Thornton CA <br />ZIP CODE <br />95240 - <br />COUNTY <br />San Joaquin <br />D . OPERATOR <br />(PUBLIC AGENCY) <br />1 <br />AGENCY NAME <br />County of San Joaquin Department of Public Works <br />MAILING ADDRESS <br />P.O. Box 1810, 1810 East Hazelton <br />CITY <br />Stockton CA <br />ZIP CODE <br />95201 - <br />COUNTY <br />San Joaquin <br />E. OPERATOR/AGENCY CONTACT PERSON INFORMATION <br />CONTACT PERSON Hudson Alison <br />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (209) 468-3066 <br />DTSC 8464 (9/92) Page 1 of 4 <br />FS/ADMINFORMS\PBR FORM <br />