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EPA ID NUMBER CAL000048992 Page N of 3�� <br /> MAILING ADDRESS, IF DIFFERENT: <br /> COMPANY NAME (DBA) _LONGS DRUG STORF CALIFORNIA INC <br /> STREET 5065 DEER VALLEY ROAD <br /> P.O. BOX 5010 (ATTN: PROPERTY ACCTG. ) <br /> CITY ANTIOCH STATE ZIP CA 94509 8311 <br /> _ - <br /> COUNTRY ------ <br /> (only complete if n USA) <br /> CONTACT PERSON NANCY SCHNDIER PHONE NUMBER 510 210 - 662:. <br /> (Fits Nsme) (Ln Name) <br /> M. TYPE OF COMPANY: STANDARD INDUSTRIAL 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 aaivirv. <br /> Example: 7384 Photofinishing lab 3672 Printed circuit boards <br /> First: 5912 RETAIL CHAIN DRUG STORE Second: <br /> IV. PRIOR PERMIT STATUS: Check yes or no to each question: <br /> YES NO <br /> ❑ 11--3 L Did you rile a PBR Notice of Intent to Operate,(DTSC Form 8462) in 1992 for this location? <br /> 13E32. Do you now have or have you ever �-1d a state or federal hazardous waste facility full permit or interim <br /> status for any of these treatment um—! <br /> ❑ 9 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 /> ❑ K27 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 /> ❑ ® 5. Has this location ever been inspected by the state or any local agency as a hazardous waste generator? <br /> V. PRIOR ENFORCEMENT HISTORY: Not required frnm gaterators only notifying as conditionally eter„pt <br /> YES NO N/A <br /> ❑ ❑ 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 const: ;te an order and need not be reported unless <br /> it was not corrected and became a final order.) <br /> ❑ If you answered Yes, check this box and attach. 'isting of convictions,judgments, settlements, or orders and a <br /> of the cover sheet from each document. (See the Instructions for more information) <br /> DTSC 1772 (1/93) Page 2 <br />