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• CLme ron•-Yakima. Inc_ <br /> r.gbkunuina Spent,Sjkrb-.n_ShiRMont Form - <br /> Ao Not Complete This Dox <br /> Approval Daae$ Verified Nor <br /> Upproved b r Titlar <br /> Generator likformatk= <br /> 1. original Profile Numbers 10-286 <br /> 2. Generating 8aailityt Regal Station 604 (Wicklaad Properties ) <br /> 3. ZPA I.II. Numbort CAD 981418502 <br /> 4. generator Addreeas Wickland Properties <br /> (mailing) P . 0 . sox 13648 <br /> Sacramento , CA 585'3- 4648 <br /> (SLt:e addreee can not change) <br /> 5. Generator Technical Repreeentativer George 1 . Converse r <br /> 6. Phone Na. r (916) 668-5300 Title= 'VP/Pr3 . Mng Western Geo-Engineers <br /> • 7. Oenerator Suoi.ness Reprtamentativei John Mar owski <br /> S. Phone No. t (916) 921 -11 00 1 TitISI M r . Environmental Affairs <br /> ffer•viae rgntact <br /> West:ates Carbon, Inc. <br /> Mark Bailey <br /> � I <br /> Phones 2ia-722-•7500 r <br /> FAX t 213722-8419 <br /> 2 110 gl vapor scrubs <br /> BX=APRXD1 Auantityt 3 unitsr 55 g1 ri1$uws R604-52192 <br /> I <br /> Antioipated 3hippi.nq Oatet 5/21 /92 <br /> 2MMUTOR CL"RTIFICATION <br /> I hereby certify that to the heat of mfr knowlaage, the chemical <br /> Contaminants and potential hazards related to thio ahipmont are Ldontiaal t.hoes i <br /> disclose an th riginal 03pcnt Carbon Profile Form' <br /> Agent for Wickland Properties 5/19/92 <br /> signetu Title Date <br /> George L . Converse V _ P . /Pr3 . Mgr Western Geo-Engineers <br /> NnMe (typo or print) Title (typo or print) (agent for Wickland ) <br />