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n <br />FACILITY NAME Tracv Municipal Airport <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />F. CONTRACTOR INFORMATION (if applicable) <br />NAME MSE Environmental <br />MAILING ADDRESS 880 West Verdulera Street <br />IDNUMBER CAH111000857 <br />CITY Camarillo CA ZIP CODE 93010 - <br />G. CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br />CONTACT PERSON Vanderwal Sharon <br />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (707) 747-5589 <br />H. ACCEPTANCE OF COMMERCIAL WASTES <br />YES NO <br />IX 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 />�X Environmental Management <br />�X Fire Department <br />❑X Law Enforcement <br />❑X Traffic <br />X❑ Air Quality <br />J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION <br />OF THE THHWCF: <br />No local permits required. <br />DTSC 8464 (9/92) <br />FS/ADMINFORMSTBR FORM <br />Page of 4 <br />