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REGEIIIED <br /> Statement of Exemption JAN 12 2012 <br /> OFHCE F M RG NC�Y SERVICES <br /> Statement of Exemption: to be completed only if you do NOT have to prepare a plan. Verify <br /> exemption with the CUPA or Administering Agency(AA). <br /> Business Name: T-MOBILE WEST CORPORATION (SITE ID#SC07243A ) <br /> Business Address: 1805 N CALIFORNIA STREET <br /> City STOCKTON Zip Code 95204 <br /> Business Telephone: ( ) UNMANNED FACILITY <br /> I understand the requirements for submitting a Hazardous Materials Business Emergency <br /> Plan. I declare,under penalty for perjury,that a Hazardous Materials Business Emergency <br /> Plan is not required for this business. <br /> Business Owner/O r r Name: T-MOBILE WEST CORPORATION <br /> Signature: Date: 12/16/2011 <br /> Title of Signer: MANA �R—ENG I NEER ING <br /> Emergency Telephone of Owner/Operator(24-hour contact): (888) 662-4662 <br /> Reason you believe your business is exempt: <br /> This unmanned cell site location is exempt from the hazardous materials business plan requirements, as <br /> specified in the California Health &Safety Code, Chapter 6.95,Section 25503.5 (b)and/or.(c),for the <br /> following reasons: <br /> It does not handle a hazardous material,waste,or a mixture containing a hazardous material, in total <br /> quantities equal to or greater than: <br /> • 500 pounds of solids <br /> • 55 gallons of liquids <br /> • 200 cubic feet of compressed gasses at standard temperature and pressure <br /> • Quantities of radioactive materials for which an emergency plan is required pursuant to <br /> Parts 30,40 or 70 of Chapter 10,Title 10, Code <br /> Should a modification to this location be conducted in the future that would raise the levels above the <br /> required reporting thresholds listed above a full HMBP and BEP will be submitted to county CUPA,AA, <br /> PA, FD or DEHS. <br /> T-MOBILE West Corporation,1855 Gateway Blvd.,'C'"Floor,Concord:CA 94520 <br />