LEGAL NAME OF CORPORATE ENTITY:
|LEGAL NAME OF CORPORATE ENTITY: |
|Claw Dry Cleaners |
|MAILING ADDRESS: |
|139 Anywhere Street |
|CITY: |STATE: |ZIPCODE: |
|Matthews |North Carolina |28105-0001 |
|CORPORATE CONTACT PERSON: |TITLE: |
|Sami Claw |Owner |
|TELEPHONE: |FAX: |E-MAIL: |
|704-336-5500 |704-336-4391 |MCDEP01@Co.Mecklenburg.NC.US |
|SITE NAME (if different from above): |
|Claw Dry Cleaners - Downtown |
|MAILING ADDRESS: |SITE ADDRESS: |
|139 Anywhere Street |700 North Nowhere Avenue |
|CITY: |CITY: |COUNTY: Mecklenburg |
|Matthews |Charlotte | |
|STATE: |ZIP CODE: |STATE: |ZIPCODE: |
|North Carolina |28105-0001 |North Carolina |28202-2222 |
|ONSITE CONTACT PERSON: |TITLE: |
|Butch Rocker |Shift Supervisor |
|TELEPHONE: |FAX: |E-MAIL: |
|704-336-5500 |704-336-4391 |MCDEP01@Co.Mecklenburg.NC.US |
| | | |
| | | |
|IS THERE DRYCLEANING EQUIPMENT ON-SITE? |( ( ) YES |( ) NO, the location to which we take clothes is: |
| | |___________________________________________________________________ |
|Circle the appropriate equipment type and fluid type |
|Equipment |EQUIPMENT |DRYCLEANING |GALLONS (and TYPE if OTHER) |INSTALLATION |RATED CAPACITY |
|ID |TYPE |FLUID |OF FLUID USED |DATE | |
| | | |IN 2003 | |POUNDS PER LOAD |
|(Example) |Dry-to-Dry |PERC |98 |1995 |35 lbs |
|A-1 | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
|(Example) |Dry-to-Dry |PERC |700 |1959 |90 lbs |
|A-2 | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
|New Machine |Dry-to-Dry |PERC |4002 |2004 |70 lbs |
| | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
| |Dry-to-Dry |PERC | | | |
| | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
| |Dry-to-Dry |PERC | | | |
| | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
| |Dry-to-Dry |PERC | | | |
| | |STODDARD SOLVENT | | | |
| |Transfer |OTHER | | | |
|Does someone live directly above or beside your facility? |( ) Yes ( ( ) No |
|Was there a Drycleaning Establishment that used perc at this location? |(( ) No ( ) Yes, but perc was last used in this year: _____________ |
|The undersigned certifies that all information and statements provided in the application, based on information and belief formed after reasonable inquiry, are true, |
|accurate, and complete. |
| |
| |
|_______________________________________________________________________________________________ |
|Signature of responsible company official Date |
|RESPONSIBLE COMPANY OFFICIAL: (Print Name) |TITLE: |
|Sami Claw |Owner |
| |
|MAILING ADDRESS: 139 Anywhere Street |
|CITY: |STATE: |ZIPCODE: |
|Matthews |North Carolina |28105-0001 |
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For office use only. Date received.
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