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a. ,yew Change....�_._. Edit (PROG33) miied 5/1 M <br /> W! <br /> GENERAL PRW FILE <br /> FACILITY Ib M FACILITY NAME Central Cellars y <br /> xEitD 10 0tiles PRIOR 5VEEPS/GGfp <br /> DAIRY: Grads ► Milt 9isPansar - <br /> mer of containers in Matti-Mead Unit <br /> lnod►ce Stand �� for Plant' <br /> Restaurant Market Ovuaissary llobf Le Farad ,,,� <br /> 5iatino ppacity'�_ FL ' Market u/Food Prep:J Y /' 11 Yurber of vending Macihfmres ' <br /> toed vehicle Mats tic�se if, Registration Cotor <br /> NAZJRDdlS WiSTE: Tons Generstd/Yr � TIERED PERMIT Facility . . <br /> HOUSING., Hota!/Mo#al He. of Units' .fait/Exeapi Instfusian <br /> =-:• �. Apprex bataa of *=V&nW �./—J—...—• to <br /> Esptayee Ilasir+a Mo. of Ewtvices <br /> Yard Chmital Tol tau Iia- Pact*" Tx Plant <br /> LIQUID WASTE:' Pumper vehicte r ,, pugnr. �. ""~� . <br /> � xtitl*d Nursing �.� Lb Generator <br /> MESe raemweratar „ <br /> DtCAt U STE: Pri�ry Care --„� Wite Care Transfer Sia ltd Vaster r� Wt Ctinic!^ <br /> storage (2-10) 5tarsge C11-SC) Stomp* i X30 ) -� ra <br /> :•�; flatural pathinp Ptace <br /> R$CpEATIOItAL NEALTM: Poo[/5�e � of Pools Cut of SerYicr Poo[ <br /> + SITE ItITIrWTICII: Enwiron Assess UST/C[P Loc Max [caste Other <br /> Nsz Mat PPL �_ <br /> Other Lead Agancy $its AllerCY: Ri�.'L bTSC NPt Sitr R8/IlZD Q <br /> SOLID AM: LardHlt . Trae+aflr Ste,�_ Recycling Fac Vast* Stomp . Fw All VasWL"O�t Site <br /> Stat i orasry Coepecur Site <br /> Sw vehicle _.,ate. <br /> VECTOR =NTIA: lout-try Fere 1�,,. Mac Yuvfoer of BindsDAY mica <br /> 1XER58ltGY 1WTIFIC%T1CQ for this FACILITT argUOr PROGRAM <br /> Vernon DeWu.l� 204,t 3_..6. 5151---- c109) 931 -�35$--- <br /> CONTACT 2 <br /> PROGMELEMEIi71p <br /> 2i�> J d CART STATUS <br /> DESIGNATED EI�PLaYEE. g �� l <br /> EPA <br /> g Of UNITS CAC0001019 49 u'� Ia+sysrnaM aaK -- <br /> 81LLi><!. AQOiQdtf�D�s 1, the undersigned ower, oprrator or apaet,of Sam, adhhn"Oke that all site and/or project specific <br /> PNS/END bwrly charges associated with this fatitfty or activity will be billed to the party i <br /> an - <br /> this fame. �;;,,ii. �j� �� <br /> fonped Witt be done In;ie�Rn'dinw!* alt SI►N <br /> :S~ Leo certify that I have prepared this iaatian and t at the worth to be gam' <br /> ioivaLit>t t1i1MTY ardtnsnce and st s e .ed t Lahr. ' , E NV i RO N M O AL HEALTH <br /> - -.. I' MIT/SERVICES <br /> :;+ADPLICAMT'S 5IWATIIR9 <br /> •':%:'•.'�•:/a{]• •. <br /> iicte_Vice President Iles Coast ' e <br /> icrbte, arrrer, operator or asent of arae. of <br /> AUTHORIZATION TO RELEASE IYFORIUTtoM: is addition to the abor�, When apPt and alt result=, geateshnicaL data and/or <br /> She praprrty located sit the above site address hereW authorize the release of a+'ry <br /> .�mrriranarntal/site a;sssstprrst ea roan as <br /> inforaaticn to SAM 10M TV CMXTT PUBLIt�a �S�[YiC�3 �WhI11t0ib1E11TLt �� 6IYiSId1 <br /> it is avaltabte and at iNs snare Hama itis pravidad tone yr Try' epr <br /> p« hoot Awnt Paid <br /> Date of Payaar! P*ymwn Type RaGeipt f Chock # Reevd BY <br /> Z3� <br /> Acer UMI_ <br />