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I®A2300279 <br /> SAN JOAQUIN Environmental Health Department <br /> - — COIJ NTY - — <br /> HAZARDOUS MATERIALS O�SCLOSU RE SURVEY <br /> A separate survey form is required for each business name antl/or address In San Joaquin County. <br /> 6uaineaa Name: Wildcat Renewables, LLC Telepngne: <br /> euainaaa site Aaareaa: 11620 E. Copperopolis Rd Stockton, CA 95125 <br /> rylailing Adareaa(if different from above>: 44 Montgomery Suite 3150 San Francisco, CA 94104 <br /> euainaaa owner(a) Nama: Same as Business Name Telephone: <br /> euainaaa owner Atltlreaa: 44 Montgomery Suite 3150 San Francisco, CA 94104 <br /> Nature of euainaaa: Solar Energy Facility FIre DlatrlcT Linden-Paters <br /> Q1. o Ves u No Does your buainasa handle a hazardous material in entity at any ane time in the year? <br /> Sae[he def ninon of hazardous malarial on page 2 of tM1is fano. <br /> v Vas ®No Does your business generate.treat.or store a hazardous waste in antiiv?(used oil,used <br /> antifreeze,waste solvent,etc.) <br /> IT your answer Is"No^to both quas[lona In D;please prin;al9q and data tba bottom W tbla form antl return to the atldraas abeva. <br /> Q2. v Yes m No Does your buslnasa handle a hazartlous material,or a miMure containing a hazardous material, <br /> n a quantity equal[o or greater than 55 gallons, 500 pounds,or 200 cubic feat at any one Pima <br /> In[he year4 <br /> If"Vas", how long have you handled[hese materiels at your buslness9 <br /> If"Yea", check any of iha following conditions that apply to your business: <br /> v A. Tha hazartlous materials hantlletl by this buslnasa era containatl solely in a consumer product <br /> packaged for direct distribution to antl use by the general public. <br /> 0 6. This buainasa operates a farm for purposes of cultivating the soil, raising or harvesting an <br /> agricultural or horticulture)commodity. <br /> Q3. o Ves a No Does your business handle an Acufaly Hazardous Material? Sea definition on page 2. <br /> Q4. v Yas s No Is your business within 1,000 feet of the quer boundary of a school?(Gradaa K-12) <br /> I have read Tha information on this form and understand my requirements untler Ghaptar 5.95 of the California Health and Safety <br /> Code(HSC). I understand that if I own a facility or property that is used by tenants, it is my responslblllty to notify the ianants of the <br /> requUamanta which must ba mat prior to is ante of a Certificate of Occupancy or beginning of operatlons. I tleclare untler the <br /> penalty of perjury that[ha infonna[ion provided on[his disclosure survey is[rue and accurate to the best of my knowledge. <br /> If you answered"Yas"[o Question 2,please gp online to cars calega v to submit your hazardous mafarials information. <br /> Owner or Authorized Agani: <br /> print Name: Ste�phaa_,nie Loucas Dam: 12/4/2023 <br /> signature: O � Tl:la: Chief development Officer <br /> 1868 E Hazelton Avenue Stockton, California 95205 I T 209 468-3420 F 209 464-0'138 www.sjcehd.com <br />