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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 />ā‘X INITIAL NOTIFICATION REVISED NOTIFICATION Put an <br />asterisk in the left margin next to the <br />revised information. <br />Iā€¢ GENERAL INFORMATION <br />A. FACILITY ID NUMBER CAH111000526 <br />B . FACILITY NAME North Countv RecycIine Center <br />C . FACILITY ADDRESS OR LEGAL DESCRIPTION OF FACILITY <br />LOCATION <br />ADDRESS 17900 East Harnev Lane <br />CITY Lodi CA ZIP CODE 95376 - <br />COUNTY San Joaquin <br />D . OPERATOR (PUBLIC AGENCY) <br />AGENCY NAME <br />MA -ING ADDRESS <br />CITY <br />County of San Joaquin Department of Public Works <br />P.O. Box 1810. 1810 East Hazelton <br />Stockton CA ZIP CODE 95201 - <br />COUNTY San Joaquin <br />E . OPERATOR/AGENCY CONTACT PERSON INFORMATION <br />CONTACT PERSON <br />PHONE NUMBER <br />DTSC 8464 (10/97) <br />, VADMINFORMSIPBR FORM <br />Hudson <br />(LAST NAME) <br />(209)468-3066 <br />Alison <br />(FIRST NAME) <br />Page I of 4 <br />