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FACILITY NAME Central Valley Waste Services Lodi Transfer Station ID NUMBER CAH777001696 <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />F. CONTRACTOR INFORMATION (if applicable) <br />NAME Clean Harbors Environmental Services, Inc. <br />MAILING ADDRESS 3201 Evergreen Avenue <br />CITY <br />West Sacramento CA ZIP CODE 95691 - <br />G. CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br />CONTACT PERSON Fisher Chris <br />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (408) 666-5086 <br />H. ACCEPTANCE OF COMMERCIAL WASTES <br />YES NO <br />k] 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 />MX Fire Department <br />TX Law Enforcement <br />XM Traffic <br />XD Air Quality <br />J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION <br />OF THE THHWCF: <br />No local permits required. <br />DISC 8464 (9/92) Page of 4 <br />FS/ADM INFORM STBR FORM <br />