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State of California - Environmental Protection Agency <br />Department of Toxic Substance Control <br />FOR OFFICIAL USE ONLY <br />DTSC 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 />❑- INITIAL NOTIFICATION <br />I • GENERAL INFORMATION <br />A. FACILITY ID NUMBER <br />B. FACILITY NAME <br />CAH 111000526 <br />North County Recycling Center <br />REVISED NOTIFICATION Put an <br />asterisk in the left margin next to the <br />revised information. <br />C . FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 17900 East Harney Lane <br />CITY <br />Lodi <br />CA ZIP CODE 95376 - <br />COUNTY <br />San Joaquin <br />D . OPERATOR <br />(PUBLIC AGENCY) <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 <br />CA ZIP CODE 95201 - <br />COUNTY <br />San Joaquin <br />E . OPERATOR/AGENCY CONTACT PERSON <br />INFORMATION <br />CONTACT PERSON <br />Hudson <br />Alison <br />(LAST NAME) <br />(FIRST NAME) <br />PHONE NUMBER <br />(209) 468-3066 <br />DTSC 8464 (10/97) <br />FS/ADMNFORMS\PBR FORM Page 1 Of 4 <br />