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07/10/1998 15:54 8059878718 P4SE EWIROHMENTAL PAGE 02' <br />r <br />State of California • Emlronmental Protection Agency Department or Toxic Substance Control <br />FOR OFFICIAL USE ONLY <br />VTSC REGIONAL OFFICE <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 />FX INITIAL NOTIFICATION F-1 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 <br />B. FACILITY NAME <br />CAH 111000318 <br />Salas Park Parkin¢ Lot <br />C , FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 2001 South Stockton Street <br />CITY Lodi CA ZIP CODE 95240 - <br />COUNTY San Joaquin <br />D . OPERATOR (PUBLIC AGENCY) <br />AGENCY NAME County of San Joaquin Department of Public Works <br />MAILING ADDRESS P.O. Box 1810, 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 />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (209) 468-3066 <br />DTSC 8464 (9/92) Page 1 of 4 <br />F8IADMINFORMSIPBR FORM <br />