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EPA ID NUMBER c-anoQ91 Page ". of 23 <br /> ------------- <br /> ,NIAILING ADDRESS, IF DTFFE N-T:--- j - - <br /> COMPANY NAME (DBA) T6 AQ1%.111h AWUbS1?NG' 5-TVWLTWV,0S P) <br /> STREET —BQx-5�8 t} --- --------- / <br /> CITY Stnr-ktnn STATE (-A_ ZIP 99206 -3853 <br /> COUNTRY _ <br /> (only wmplets if not USA) <br /> CONTACT PERSON Lon' Kitagawa PHONE NUMBER 2( O9 ) 983 - 3339 <br /> (Fwu Name) (Last Name) <br /> III. TYPE OF COMPANY: STANDARD MUSTRIAL CLASSIFICATION (SIC) CODE: <br /> Use either one or two SIC codes (a four digit number) that best describe your company's products, services, or industrial activity. <br /> Example. 7384 Photofinishing tab 3672 Printed circuit boards <br /> First: 3728 Aircraft parts,--n.e.c. Second: 3769 Space vehicle parts, n.e.c. <br /> IV. PRIOR PERMrr STATUS: Check yes or no to each question: <br /> YES NO <br /> ❑ ® 1. Did you file a PBR Notice of Intent to Operate (DISC Form 8462) in 1992 for this location? <br /> ❑ ® 2. Do you now have or have you ever held a state or federal hazardous waste facility full permit or interim <br /> status for any of these treatment units? <br /> ❑ ® 3. Do you now have or have you ever held a state or federal full permit or interim status for any other <br /> hazardous waste activities at this location? <br /> ❑ ® 4. Have you ever held a variance issued by the Department of Toxic Substances Control for the treatment you <br /> are now notifying for at this location? <br /> Q ❑ 5. Has this location ever been inspected by the state or any local agency as a hazardous waste generator? <br /> V. PRIOR ENFORCEMENT FIISTORY: Not nupdrad from generators only notifying as conditionally cu=pt. <br /> YES NO <br /> El ❑ Within the last three years, has this facility been. the subject of any convictions,judgments, settlements, or final <br /> orders resulting from an action by any local, state, or federal environmental, hazardous waste, or public health <br /> enforcement agency? <br /> (For the purposes of this form, a notice of violation does not constitute an order and need not be reported unless <br /> it was not corrected and became a final order.) <br /> LJ If you answered Yes, check this box and attach a listing of convictions,judgments, settlements, or orders and a copy <br /> of the cover sheet from each document. (See the Instructions for more information) <br /> DTSC 1772 (1/91) Page 2 <br />