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, A <br />I <br />IFACILITY NAME homton New Hope School Parking Lot JID NUMBER ICAH 111000527 1 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />F. CONTRACTOR INFORMATION (if applicable) <br />NAME MSE Environmental, Inc. <br />MAILING ADDRESS 880 West Verdulera Street <br />IC I T,' Camarillo CA ZIP CODE <br />93 . 010 — <br />G. CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br />CONTACT PERSON Oldemeyer ' anice <br />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (805) 987-0217 <br />H. ACCEPTANCE OF COMMERCIAL WASTES <br />YES NO <br />II I X I Will your facility accept wastes from small quantity commercial source generators? <br />THE FOLLOWING LOCAL AUTHORITIES HAVE BEEN NOTIFIED OF THE <br />INTENDED OPERATION OF THE THHWCF: <br />I <br />X Environmental Management <br />X Fire Department <br />X Law Enforcement <br />X Traffic <br />X Air Quality <br />71 <br />.......... <br />- ---------- . . ......... . . .. . . ........ . <br />J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION <br />nP THP THHWCF- <br />o local permits required. <br />DTSC 8464 (9/92) Page 0 of 4 <br />FSADMINFORMSTBR FORM <br />