Loading...
HomeMy WebLinkAbout15200 Transistor Ln - CofO (2)I ri SUPPLEMENTAL INFORMATION ) #7 1. BUSINESS ADDRESS « 7ZWEolJ6T®N ��ilce4/ 2. Person to ccntact in case of emergency. ��ALi3yl�Gv� Telephone numher: ' ��3 - 2K eS " 3. Does the buildingin y? question have electricity? �( Yes ❑ No k4 (a) If No, are ; you requesting that the - electricity be ❑ Yes -turned on? ❑ No 4. The building is; sprinklered? Z Yes ❑ No 5, Operations., will produce • du5t,-/ wood = shavings or similar material? Yes No No a 6. Operations will involve the repair or replacement c>f ❑ Yes automobile parts? No If Yes: (a) Describe the components repaired or replaced. i ,!I (b) Does the operation involve the use of an open #lame? sj ❑ Yes No 7. The business is drinking,dining or assembly use that will result in an occupant load of more than 56 persons.. El Yet No: 8. The foili�ac,�., est describes my operation; office Ony q:50 fi VV Manufacturing / Distribution (describe process and end, product)( r E Restaurant / Take; Out Food ;a Medical / Dental Other (describe) _ ION ` SUPPLFi11 EN-TAL....!NFORMATIDN, (Continued) iiiaterials- K ales Vj z ❑ No f !f. Yes.,, indid�afe'"►r�ai�tt�t.esM�.< ; Nlateriaj% i; t ..�,.� Quantity ?. Flamrb#e`-figiEc3s='_ F Class i-A 2 } Class I-B -Class I-C 2. Combustible liquids' �^ Class 11 ' Class Ill -A 3. Combination flammable liquids Ica 4_ - Flammable gases d 5. •;, Llooefied flammable gases 6. Flammable fibers - loose q 7. "Plammabse fibers - baled f ZA 5 8. �- Flammable solids 3 9. Unstable materials 10. Corrosive liquids ' 11, Oxidizing material.- gases 12. Oxidizing �material liquids 13, — 'Oxidizing material - solids d 14. ; .'Organic peroxides 3 15. Nitrometnane' (unstable materials) 16>, , Ammonium nitrate f 17. Ammonium nitrate compound mixtures i containing more than 60% nitrate a °t by weight > 18. Highly toxic material and opaisonous ,gas ,19.` Smokeless powder 20, Black sporting powder I hereby certify the Bove information ` is true and a correct to the best df y know _ ... ^-- ©reap i tllre late F gg55j i s } Sf ' Seth Coast AIR uALtTY MANAGEME�I DISTRICT' 21865 E. Copley Drive, Diamond Bar, CA 91765-4182 (909j 396 2000 i AIR QUALITY PERAUT CHECKLIST t for nonresidential, buildings only { Company Name: Jc'2 149 5 Location. of Property: _ f 5' P00 7 ?AN5 r s %R City; 671Y �19 Cfi� Zip Code: E Contact Person: t?ATitle:S/ 2Fh177 Telephone Number: (30-V5Vy- 7Y 8. s' Fax Number: FF3- 31 C-I Type of IndustryMusiness: To apply for a nonresidential building permit, you must complete this checklist. If you have any ; questions about completing this checklist, please call (800) 388-2121 YES NO 1. Will the ,facility have a charbroiler? 2. Will any internal combustion engine with greater than 50 horsepower operate at the facility (excluding motor vehicles)? ] (] 3. Will operations at the facility involve mixing, blending, or processing of solvents, adhesives, paints or coatings? [ ] [ 4. Will; dust or smoke be generated at the facility? 5: Will refining of any liquids or solids be done at the facility? 6. Will any plating or coating of materials be done at the facility? L ] a 7. Will any, combustion equipment rated greater than 2,000,000 BTU/hr be operated at the facility? [ ]] 8. Will any, acids, solvents, or motor fuel be used or stored at the facility? [ ]] 9. Will any organic liquids or gases be reacted or produced?'J 10. Will any ovens be used to, dry or cure products at the facility? 11. ; Will an CFC (Freon) recycling machines operate at the facility? ; �f Applicant: t yvR�'G�/ Signature:' (Print name clearly) Y If you have marked "NO" in -all the boxes, an air quality permit is needed at this time, and this checklist is your written release. If you markets "YES" in any of the bees, you must contact the Sou' h Coast Air Quality i Management District (AQAM). Please read the requirements on the back of the checklist. (800) 388-2121 . AU{ lTlQ1 RL :Jf PLEMEIuTfaL INFORMtS" ="vN .' f