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- 07-02-1998 05:06PM FROM <br />State of California - Environmental Protection Agency <br />FOR OFFICIAL USE ONLY <br />1Yr5C REGIONAL OFFICE <br />MSE Enk,ironmental, Inc. TO 912094683078 P.04 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />1hparsment of Toxic Substance Control <br />For use by agencies operating a Temporary Household Hazardous Waste Collection Facility (THHWCF) under Permit By Mule. Each <br />location requires a separate form. <br />MX INITIAL NOTIRCATION 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 CAH111000681 <br />B . FACILITY NAME Park and Ride Parking Lot <br />C . FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 178 Industrial Ave. <br />CITY Ripon CA ZIP CODE 95366 - <br />COUNTY San Joaquin <br />D . OPERATOR (PUBLIC AGENCY) <br />AGENCY NAME Coun of San Joaquin Department of Public Works <br />MAILING ADDRESS 1810 East Hazelton <br />CITY Stockton CA ZIP CODE 95201 - <br />COUNTY <br />San 3oaquin <br />E. OPERATORIAGENCY CONTACT PERSON INFORMATION <br />CONTACT PERSON Hu&on Alison <br />PHONE NUMBER <br />(LAST NAME) <br />(209)468-3066 <br />(FIRST NAME) <br />DTSC 8464/92) Page I of 4 <br />FS/ADMINFORMSIPB FO <br />