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---------- <br /> State of Callilofftia-California Environrnental Pr0Wfi0"Agency Deparom,trit of Toxic Substances Control <br /> Notim of intent to Handle and Treat or Rwyr-le <br /> Universal Waste Electronic Devices(UWEDs)and/or C3thOde Ray Tube(CRT) Matetials <br /> A. Handier Information E22CCFZ ser-tions66273.13f.33(d)(2)(A)(1)-(7).and 66273.82(a)(1)-(T}]. P102sO fill in <br /> Ha'"' <br /> �the information Muested below. <br /> Handler(Facility)Name Onsite Electronics Re�cycljn Phone (209) 9814677 <br /> Physical Address 1333 E. Turner Lane Lodi sari Joaquin CA 05241 <br /> Street city Ccurity State Zip <br /> Mailing Address 207 W, Los Angeles Ave.*337 Moorpark Ventura CA 93021 <br /> Street city County State zip <br /> Contact Person(Namerritle) Janice OlderneyPhone(_ZO_9 ) 9814677, <br /> Mailing Address 207 W. Los Angeles Ave.#337 Moorpark Venture CA 93021 <br /> Street city county State Zip <br /> Facility Owner USA Waste of California,dba Central Valley Waste Phone (209) 333-5611 <br /> Mailing Address 1333 E.Turner Lane Lodi , Son Joaquin -- CA 96241 <br /> Street city cr.)Unty State Zip <br /> E-Mail address jolderney!Eeaol.com (if ave#affle) <br /> EPA 10 Number (if applicable) <br /> S. Proposed Handling Activities E22 COR sections 66273.131.33(d)(2)(A)(S)-(9)and 66273.82(a)(8)- <br /> please check the box(es)that describes the sou s)Of the materials YOU will GPIW'-t- PW980 chet*the <br /> box es)that describes the of malerlals you will collect. Check all applicable boxes. <br /> Materials Accepted From: pilaterials;to Be Handled <br /> (deck all ttwt apply) <br /> rF1 <br /> MX Businesses CRT Materials tIj <br /> Households M UWEDs <br /> Government agencies rKI Universal Waste Batteries <br /> =9 <br /> Other collectors Ui� universal Waste Lamps <br /> Exempt Circuit Boards <br /> Other please specify -- "I <br /> M-1 <br /> Other Scrap Metal <br /> Please specify where you intend to send the materials you v411 receive from Oftit)B resources, if you intend to <br /> C:. Please <br /> materials,Elease co ach additional sheets It needed. <br /> Destination Facility or Handler Materials Shipped <br /> (check all that WW) <br /> 1, Name EnvirocLde_ Rare CRTs <br /> CRT Devices <br /> Address 11383 N=ort Drive Rancho Cucamonga CA 91730, E(] CRT Glass <br /> Street city State Zip 1C UviaDs <br /> Country United States Phone(909 ) 98"688 Universal Waste Batteries <br /> universal Waste Lamps <br /> Mailing Address 11383 Newport D(Ive Rancho Cucamonga GA 91730 [j Exempt circuit Boards <br /> Street city State Zip J Other Scrap Metal <br /> Country United States <br /> EPA ID number fff appik-,able) <br /> OTSC 1388(11116104) Page 1 of 6 <br />