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State of Califoinia-California Environmental Protection Agency Department of Toxic Substances Control <br /> TIERED PERMITTING PRASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> SECTION I:FACILITY INFORMATION <br /> Instructions:Complete the following descriptive information about your facility. This information accurately describes the location of your facility <br /> and establishes mailing and phone.contacts. If facility location and[nailing address are identical,you may put:"stone"into facility mailing address <br /> SpaCc. <br /> Type of Permit: Permit by Rule X Conditional Authorization <br /> ............................. ......... .. ................. ......... ................. ......... ......... .._.................................. .. ......... .................... ........... _ . .. ...... <br /> i. CtJItRENTFACILITY NAME: Metal Finishing Solutions, Inc. <br /> PAST NAMES(Attach additional pages if necessary): <br /> 2. EPA I.D.NUMBER: CAR000285262 <br /> 3. NAME OF FACILITY OWNER(see definttionofowner)• Metal Finishing Solutions, Inc. <br /> ......... ......... <br /> 4. NAME OF FACILITY OPERATOR: Metal Finishing Solutions, Inc. <br /> 5. NAME OF PROPERTY OVER: Michal Laptalo <br /> 0. FACILITY LOCATION ADDRESS: <br /> STREET: 1325 EI Pinal Drive <br /> CITY: Stockton <br /> COUI7Y: San Joaquin <br /> STATE: CA ZIP CODE: 95205 <br /> 7. FACILITY MAILING ADDRESS(if different from FACILITY LOCATION ADDRESS): <br /> STREET: 2360 Zanker Road <br /> CITY: San Jose <br /> STATE: CA ZIP CODE: 95131 <br /> ..................__._...._._................................._.........._............................................................................................................................................................._........................._..................._..............................................................__........_._............. .... <br /> 8. FACILITY TELEPHONE NUMBER: (925) 872-1263 <br /> ......... .......... . ......... ......... ........... .... . __.... ........................................................................................................................... ...._... ...................._ ............................ ................ .. .. ...................... ................, <br /> 9 ....................................... ......._._...._......__.............._.......... ..................... __.......................................................................... . <br /> 10. NAME OF FACILITY CONTACT PERSON: Corey Dehl <br /> IL TLTLE OF FACILITY CONTACT PERSON: General Manager <br /> 12. PHONE NUMBER OF FACILITY CONTACT PERSON: (925) 872-1263 <br /> DTSC 17.51(0&99) Please indicate total number of pages—of—_ <br />