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State of California — California Environmental Protection Agency Department of Toxic Substances Control <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />For use by public agencies operating a Temporary Household Hazardous Waste Collection Facility (THHWCF) under Permit By Rule. Each location requires a <br />separate form. <br />El INITIAL NOTIFICATION <br />I. GENERAL INFORMATION <br />A. FACILITY ID NUMBER <br />B. FACILITY NAME <br />❑ REVISED NOTIFICATION Put an asterisk in the left margin next to the revised <br />information <br />CAH 111000857 <br />Tracy Municipal Airport <br />C. FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY LOCATION <br />ADDRESS 5749 South Tracy Boulevard <br />CITY Tracy STATE CA ZIP 95377 <br />COUNTY San Joaquin <br />D. OPERATOR (PUBLIC AGENCY) <br />AGENCYNAME County of San Joaquin <br />Department of Public Works <br />MAILING ADDRESS <br />CITY Stockton <br />COUNTY San Joaquin <br />P.O. Box 1810, 1810 East Hazelton Avenue <br />STATE CA ZIP 95201 <br />E. OPERATOR/AGENCY CONTACT PERSON INFORMATION <br />CONTACT PERSON Andrews Kimbra <br />%-- ------/ <br />PHONE NUMBER (209) 468-3066 <br />(FIRST NAME) <br />DTSC 8464 (revised 10/07) PAGE 1 OF 4 <br />