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ACILITY NAME ayless Food Mart Parking Lot I 0 NUMBER rAHl 1 1000595 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />K. IS THE PROPERTY ON WHICH THE THHWCF WILL BE HELD OWNED <br />BY THE OPERATOR? <br />YES NO <br />X I If not, a written agreement between the operator and the property owner is required. <br />ROPERTY OWNER'S NAME arry L. Young & Sons, Kenneth Young <br />HONE NUMBER (209) 727-5551 <br />II. DAYS AND HOURS OF OPERATION <br />Show hours using a 24-hour clock. Example: Ipm should be shown as 1300. <br />DTSC 8464 (9/92) Page ❑ of 4 <br />FS/ADMINFORMS\PBR FORM <br />