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Fran,Charles Watkins To Cate. 1/6103 Time:k'3a:06 PM Pepe 11 of 3 <br /> 01/06/03 MON 17:411 FAX W003 <br /> UNIFIED PROGRAM CONSOLIDATED FORM <br /> HAZARDOUS WA.9TE <br /> HAZARDOUS WASTE TANK CLOSURE CERTIFICATION <br /> a <br /> .ifi. Wl <br /> xet1SINE59 NAME ea,yerAtartv rare aeA-or„yBrnr Rel a FACILRY '' f <br /> Arco#434, 501 W. Kettleman Ln, Lodi -- <br /> TANK OWNER NAME <br /> Arai Products Company <br /> TANK OWNER AOORESS -- r <br /> 4 Centerpointe Drive <br /> raNK OWNER cm La Palma STATE CA ZIP COVE fM231000 w <br /> TANK Tank lDa CMWI 1, tion W Flammable Vapor Corlmbemn Or Diligent, __—_— <br /> INEMO _P4'� + 1 TOP Carder 13o0an Tp Glrter Bdtom <br /> A1� 1 3$0517011 is Q r O xee Dit.O.Yi aTa �V -Fio tU me <br /> READIN 2 3605150W <br /> T »ee 7 <br /> GS __ _ 6 <br /> 3 3P0515nOq 161 D Q 1�,i! Z i�_ r LU. �• <br /> k <br /> On eominaEon of one ferry 1 exalt the Is it is vawNy free flarrr Poled,sWW.orale MN.heky ruiduM of lank eonleme),rirsule and deMle. 1 <br /> tudher a Hit IM IrMamation Provided herein N IM and acc mta 10 the Wet of my knosadge. <br /> SIOIII RE OF CERTIFIER STATUS OR AFFILIATION OF CERTIFYING PERSON <br /> Calmer Is a taprewrlMlha of Me CUPn,.utlradzed agerrq,or LUL- <br /> no <br /> $AME OF TIFIE0. (Pm:p I <br /> ❑ Yes ® No <br /> / <br /> If rt r Y Name of COPA,ealho iaW agency,or L01: 'r'r <br /> TITLE OF CERTIFIER tl„ <br /> e/UF-' �( f�/k I r't-- C,- 3 H certmer is other than CUPA/LW cheek appropriate,box bel Taz <br /> AsoREss_ (-)'�, _�/' / /1Nm,L'Ll�el_,Q,.�iS ❑ a. Cartmel Industrtal"wris1(CIH) <br /> � ,7 x ❑ b Cardaed Safety Prufeaw l(0,t3P) <br /> CRY CeNSed McMe Chaw l(CMC) <br /> lii/G��SLl �A 9�/�� ❑ d Reloatared Environmental ttealth SPedalist(RE71SI <br /> PHONE re ❑ e. Profeaslonar Errgkeer(PE) <br /> ❑ L Clens 11 Regalemd EOvkaxMllMl Asocial <br /> DAIS ea <br /> CERTIFICATION TIME ❑ 0 hazardous ItAwde sce ramorel ww4 �,eneeo arMaetor (wRh. <br /> 11' /O�zz loz OljO hr-r <br /> TANK PREVIOUSLY HELD FLAMmA8lE OR comous nal MATERUILS <br /> (am m.rAMwbrabvyrsm rte YnMrreaeaNnaaywaelrcy ineeMs'fv xxvarre meaemar rr�l ® Yw ❑ No <br /> CERTIFlER'S TANK MANApEIyENT tNSTRUCT1pNS FOR RAP DEALER,OISPOSAI FACIL ,EiC: <br /> A agyatlJa eeMin/b arlla®mpnyyia YYt qtly rerytlhxplyapa aM1cylb,up we b"y m"GUPA.-IF ti bra ou—FAM ia Mfih .AwawOle Me ara <br /> °d. Y aware/panda of lri ank catlam rarnoxa aumaaor ri /duoma LrYar <br />