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ACILITY NAME ISalas ParK Parking Lot D NUMBER AH 1 1 1000318 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />F. CONTRACTOR INFORMATION (if applicable) <br />AME <br />MSE Environmental, Inc. <br />1XI <br />I Fire Department <br />AILING ADDRESS <br />880 West Verdulera Street <br />1XI <br />I Law Enforcement <br />1XI <br />ITYamarillo <br />ICA ZIP CODE P3010 <br />1XI <br />G. CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br />CONTACT PERSON Olderneyer Janice K. <br />.............................. .................... _.........-_._._._— ._._.. --..__...__..__...__.... --....... <br />(LAST NAME) FIRST NAME) <br />HONE NUMBER 805) 987-0217 <br />H. ACCEPTANCE OF COMMERCIAL WASTES <br />YES NO <br />1XI I I Will your facility accept wastes from small quantity commercial source generators? <br />I. THE FOLLOWING LOCAL AUTHORITIES HAVE BEEN NOTIFIED OF THE <br />INTENDED OPERATION OF THE THHWCF: <br />1XI <br />I Environmental Management <br />1XI <br />I Fire Department <br />1XI <br />I Law Enforcement <br />1XI <br />I Traffic <br />1XI <br />I Air Quality <br />J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION <br />OF THE THHWCF: <br />No localspermits required_ __..... ____..... _�— _...__... ___.__...._ _.. <br />DTSC 8464 (9/92) Page ❑ of 4 <br />FS/ADMINFORMS\PBR FORM <br />