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I ' <br /> V <br /> V _ <br /> J J , <br /> State of California-California Environmental Protection Agency <br /> Department ofToxic Substances Control <br /> TIERED PERMITTING PHASE I ENVIRONMENTAL ASSESSMENT CHECKLIST <br /> SECTION 1: FACILITY INFORMATION <br /> Instructions:ConPlete the tullnwina descr iptive information about your facility,This inforluHtion accurately describes the location ofyour facility <br /> and establishes mailing and phone contacts. If facility location and mailing address are identical,you may put"same"into Facility mailing address <br /> spaces. <br /> Type of Permit: Permit by Rule X Conditional Authorization <br /> I. CURRENT FACILITY NAME:Cepheid Bldg.2 <br /> PAST NAMES(Attach additional pages irnecessary): APR 20 201E <br /> 2. EPA ID. NUMBER: CAR000336537 CYP KtvluiNAL OFFICE <br /> 3_ NAME OF FACILITY OWNER(see definition of owner):Cepheid <br /> 4. NAME OF FACILITY OPERATOR:Cepheid Lodi, LLC <br /> 5. NAME OF PROPERTY OWNER: <br /> 6. FACILITY LOCATION ADDRESS: <br /> STREET: 121 N. Guild Ave. <br /> CITY: Lodi <br /> COUNTY: San Joaquin <br /> STATE: CA ZIP CODE:95240 <br /> 7, FACILITY MAILFNG ADDRESS(if different from FACILITY LOCATION ADDRESS): Same as Above <br /> STREET: <br /> CITY. <br /> STATE: ZIP CODE: <br /> 8. FACILITY TELEPHONE NUMBER:(888)838-3222 <br /> 9. FACILITY FAX NUMBER: <br /> 10. NAME OF FACILITY CONTACT PERSON:Lana Karpuk <br /> 11. TITLE OF FACILITY CONTACT PERSON:Sr. EHS Manager <br /> 12. PHONE NUMBER OF FACILITY CONTACT PERSON: 916-824-4586 <br /> DTSC 1151(06/99) <br /> Please indicate total numberoFpages_ of <br />