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w <br />State of California —Environmental Protection Agency <br />Department of Toxic Substance Control <br />FOR OFFICIAL USE ONLY <br />DTSC REGIONAL OFFICE <br />TEMPORARY HOUSEHOLD HAZARDOUS WASTE <br />COLLECTION FACILITY <br />PERMIT BY RULE NOTIFICATION <br />For use by agencies operating a Temporary Household Hazardous Waste Collection Facility (THHWCF) under Permit By Rule. Each <br />location requires a separate form. <br />�X INITIAL NOTIFICATION REVISED NOTIFICATION Put an <br />asterisk in the left margin next to the <br />revised information. <br />I • GENERAL INFORMATION <br />A. FACILITY ID NUMBER CAH 111000344 <br />B. FACILITY NAME San Joaquin County Fairgrounds <br />C . FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 1685 South Airport Way <br />CITY Stockton CA ZIP CODE <br />95205 - <br />COUNTY San Joaquin <br />D . OPERATOR (PUBLIC AGENCY) <br />AGENCY NAME County of San Joaquin Department of Public Works <br />MAILING ADDRESS P.O. Box 1810, 1810 East Hazelton <br />CITY Stockton CA ZIP CODE 95201 _- <br />COUNTY <br />COUNTY San Joaquin <br />E. OPERATOR/AGENCY CONTACT PERSON INFORMATION <br />CONTACT PERSON <br />PHONE NUMBER <br />DTSC 8464 (10/97) <br />FS/ADMINFORMS\PBR FORM <br />Hudson <br />(LAST NAME) <br />(209) 468-3066 <br />Alison <br />(FIRST NAME) <br />Page 1 of 4 <br />