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l:PA 11) NUMBER CAD063036776 rage7. of_7 <br /> MAH.ING ADDRESS, IF DIFFERENT: <br /> COMPANY NAME (DBA) Pacific Coast Producers <br /> STREET P.O. Box 880 <br /> CIT Lodi STATE CA ZIP 95241 0880 <br /> COUNTRY <br /> (oWy coW&M if as USA) <br /> CONTACT PERSON PHONE NUMBER( - <br /> (Futr Name) (lit Name) <br /> III. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: <br /> Use tither one or two SIC coder (a jour digit number)that best describe your company's products, servicer, or industrial activity. <br /> Example. 7384 Phomfinvhinr lab 3671 Printed arcua boards <br /> Fes: 2033 Canned Fruits & Second: <br /> Vegetables <br /> IV. PRIOR PERMIT STATUS: Chuck yes or no to each question: <br /> YES NO <br /> ❑ ® 1. Did you file a PBR Notice of Intent to Operate (DTSC 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 [nuts? <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 /> ❑ ® 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 from generators only notifying as co ditionaUy ererrpt. <br /> YES NO <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 constitute an c.der 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 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 (1/93) Page 2 <br />