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EPA ID NUMBER CAD98088 2 <br />TRANSPORTABLE TREATMENT UNIT PERMIT -BY -RULE <br />SITE-SPECIFIC NOTIFICATION <br />X. CERTIFICATIONS: This form must be signed by an authorized corporate officer or any other person in the <br />company who has operational control and performs decision-making functions that govern operation of the facility <br />(per Title 22, California Code of Regulations (CCR) section 66270.11). Both copies must have original <br />signatures. <br />OWNER Certification I certify that the unit or units described in these documents meet the eligibility and operating <br />requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary <br />containment requirements. <br />I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in <br />accordance with a system designed to assure that qualified personnel properly gather and evaluate the information <br />submitted. Based on my inquiry of the person or persons who manage the system, or those directly responsible for <br />gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. <br />I am aware that there are substantial penalties for submitting false information, including the possibility of fines and <br />imprisonment for knowing violations. <br />Curt Ja n President <br />Nam ( pe) Title <br />L Z 5 AW <br />Signatur Date Signed <br />OPERATOR Certification I certify that the unit or units described in these documents meet the eligibility and operating <br />requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary <br />containment requirements. <br />certify under penalty of law that this document and all attachments were prepared under my direction or supervision in <br />accordance with a system designed to assure that qualified personnel properly gather and evaluate the information <br />submitted. Based on my inquiry of the person or persons who manage the system, or those directly responsible for <br />gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. <br />I am aware that there are substantial penalties for submitting false information, including the possibility of fines and <br />imprisonment for knowing violations. <br />Curt Johns _ President <br />Name ( or Ty e) Title <br />�/Y/ a <br />Signatur Date Signed <br />ZOAZI o <br />You must submit two sets of this completed notification, with original signatures and attachments, by certified mail, return <br />receipt requested, to: <br />Department of Toxic Substances Control <br />Program Data Management Section -HQ 10 <br />Attn: TTU Notifications <br />400 P Street, 4th Floor, Room 4453 (walk in only) <br />P.O. Box 806 <br />Sacramento, CA 95812-0806 <br />RTSC Form 1197 (1/96) Page 9 <br />(Previously RTSC 8429A) <br />