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uvvcni�v'nJurrll.t.Ur tiVltf-iCiENGYSERVICES <br /> ,iA ACCIDENTAL RELEASE PREVENTION— <br /> ,M REGISTRATION <br /> .o (NEW 6/97) PAGE I OF 1 <br /> I �] `) 1 REGISTRATION TYPE I� UPDATE TYPE <br /> J instructions on reverse befor' I'com ng, l NEW I I UPDATE �I ADD C DELETE F-1 REVISE <br /> _asiness Owner/Operator Inform ation u <br /> dUSINE5S NAME -- . <br /> ADDRESS (Number and Street) <br /> 26200 NOWELL ROAD P.Q. BOX 108 <br /> CITY I COUNTY I STATE ZIP CODE <br /> THORNTON ISAN JOAQUIN CA 95686 <br /> OWNERIOPERATOR NAME PHCNE NUMBER <br /> TRI VALLEY GROWERS 209--794-2303 <br /> II. Regulated Substance List <br /> A. Name of Each Regulated Substance Process Max.quantity (ibs)i. CAS# <br /> I <br /> PROPANE 17 . 84774-98-6 <br /> 2. <br /> I <br /> J. <br /> 5. <br /> 6 <br /> B. Name of Each Regulated Substance in a Mixture Percent Process Max. CAS# <br /> Weight quantity (lbs) <br /> 9 <br /> I I I <br /> III. Certification <br /> I, the owner or operator of the aforementioned business, hereby certify that the registration information provided <br /> above is true, accurate, and complete to the best of my .knowledge, based upon reasonable inquiry. I am fidly aware <br /> that this certification, executed on the date indicated below, is made under penalty of perjury under the laws of the <br /> St of California. <br /> OWNERIOPERATOR NAME(PRINT} <br /> CWNERJOPERATOZRGN,)tYR8 - DATE EXE UTED <br />