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TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />F. CONTRACTOR INFORMATION (if applicable) <br />NAME PSC Environmental Services, LLC <br />MAILING ADDRESS 11855 White Rock Road <br />CITY Rancho Cqa STATE CA ZIP 95742 <br />G. CONTRACTOR CONTACT PERSON INFORMATION (if applicable) <br />CONTACT PERSON Rappaport Mark <br />(LAST NAME) (FIRST NAME) <br />PHONE NUMBER (916) 343-0399 <br />H. ACCEPTANCE OF CESQG WASTES <br />YES NO <br />El F-1 Will your facility accept wastes from conditionally exempt small quantity generators? <br />I. <br />THE FOLLOWING LOCAL AUTHORITIES HAVE BEEN NOTIFIED OF THE INTENDED <br />OPERATION OF THE THHWCF: <br />Environmental Management <br />Fire Department <br />Law Enforcement <br />Traffic <br />Air Quality <br />J. THE FOLLOWING LOCAL PERMITS HAVE BEEN OBTAINED FOR OPERATION OF THE <br />THHWCF: <br />No local permits required. <br />DTSC 8464 (revised 10/07) PAGE 2 OF 4 <br />