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State of California- California Environmental Protection Agency Department of Tone Substances Coouvl <br /> Char Numbe; Page 1 of 25 <br /> '1802°730 <br /> ONSITE HAZARDOUS WASTE TREATMENT NOTIFICATION FORM <br /> J <br /> FACILITY SPECIFIC NOTIFICATION APR 0 2 <br /> For Use by Hazardous Waste Generators Performing Treat <br /> me1tial <br /> VIRONMENTA E,�LI <br /> Under Conditional Exemption and Conditional Authorization, PERMIT/SER eLRevised <br /> and by Permit By Rule Facilities <br /> Please refer to the attached Instructions before completing this form. You may notify for more than one permitting tier by using this <br /> norificarion form, DISC 1772. You must attach a separate unit specific notification form for each unit at this location. There are <br /> different unit specific notification forms for each of rhe four categories and an additional notification form for transportable treatment <br /> units (777J's). You only have to submit forms for the tier(s) that cover your unit(s). Discard or recycle the other unused forms. <br /> Number each page of your completed norification package and indicate the total number of pages at the top of each page at the <br /> 'Page _ of_'. Put your EPA ID Number on each page. Please provide all of the information requested; all fields must be <br /> completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any <br /> attachments. <br /> The norificarion will not be considered complete without payment of the appropriate fee for each tier under which you are operating. <br /> (Please note that the fee is per TIER not per UNIT. For example, if you operate S units but they are all Conditionally Authorized, <br /> you only owe$1,140, NOT S times$1,140. If you operate any Permit by Rule units and any units under Conditional Authorization <br /> you owe$2,280.) Checks should be made payable to the Department of Toxic Substances Control and be stapled to the top of this <br /> form. Please write your EPA ID Number on the check Fill in the check number in the box above. <br /> I. NOTIFICATION CATEGORIES <br /> Indicate the number of units you operate in each tier. This will also be the number of unit specific notification forms you must attach. <br /> Conditionally F_xempt Small Quantity Treatment operations may not operate units under any other tier. <br /> Number of units and attached unit specific notifications Fee per Tier <br /> (not per unit) <br /> A. 0 Conditionally Exempt-Small Quantity Treatment (Form DTSC 1772A) S 100 <br /> B. 6 Conditionally Exempt-Specified Wastestream (Form DTSC 1772B) S 100 <br /> C. i Conditionally Authorized (Form DTSC 17720) $1,140 <br /> D. 0 Permit by Rule (Form DTSC 1772D) $1,140 <br /> 7 Total Number of Units Total Fee Attached S 1 ,240 <br /> II. GENERATOR IDENTIFICATION <br /> EPA ID NUMBER CAD 0 0 9 1 8 9 0 6 9 BOE NUMBER (if available) H A HQL 6_Q_Q�L fes,_I Z <br /> NAME (Company or Facility) BP Chemicals Inc. <br /> (DBA—Doing Business As) <br /> PHYSICAL LOCATION 3437 S. Airl2ort Airport6Vav <br /> For DTSC Uce Only <br /> CITY Stockton CA ZIP 95206 - 185 , <br /> Region <br /> COUNTY San Joaquin <br /> CONTACT PERSON Lon Kitagawa PHONE NUMBER( 209 ) 9R3 <br /> (Fret Name) (LAst Name) <br /> DTSC 1772 (1/93) Page 1 <br />