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Departmeat of Toxic Substaaca Control Su-;4'1 California-California Fart e rrotec6o 17 3/3�/ 1` Page 1 of 6 Fhest umber S - 1922v ONSITE HAZARDOUS WASTE TREATMENT NOTIFICATION FOc�orrected FACILITY SPECIFIC NOTIFICATION v For Use by Hazardous Waste Generators Performing Treatment 10 Initial VUnder Conditional Exemption and Conditional Authorization, ❑ Revised and by Permit By Rule Facilities d y` Please refer to the attached Instructions before completing this form. You may notify for more than one permitting tier by using this notocation form, DISC 1 T/1. You must attach a separate unit specific notification form for each unit at this location. There are different unit specific notification forms for each of the four categories and an additional notification form for transportable treatment units (77T1's). You only have to submit forms for the tier(s) that cover your unit(s). Discard or recycle the other unusedforms. Number each page of your completed notification package and indicate the total number of pages at the top of each page at the 'Page _ of_'. Put your EPA ID Number on each page. Please provide all of the information requested; all fields must be completed except those that stare 'if different' or 'if available'. Please type the information provided on this form and any attachments. The notification will not be considered complete without payment of the appropriate fee for each tier under which you are operating. (Please note that the fee is per 77ER not per UNIT. For example, if you operate 5 units but they are all Conditionally Authorized, you only owe$1,140, NOT 5 timer$1,140. Ifyou operate any Permit by Rule units and any units under Conditional Authorization you owe$2,280.) Checks should be[Wade payable to the Department of Toxic Substances Control and be stapled to the top of this form. Please write your EPA m Number on the duck Fill in the duck number in the bar above. I. NOTIFICATION CATEGORIES Indicate the number of units you operate in each tier. This will also be the number of unit specific notificationforms you must attach. Conditionally Erarrpt Small Quantity 7yrarment operations may not operate unity under any otlte tier Number of units and attached unit specific notifications e Services Fee per Tier O(s�O.Giations SQ (rot per Mir) A. Conditionally Exempt-Small Quantity Treatment (Form DTSC 17 2 ca` oo so $ 100 B. 1 Conditionally Exempt-Specified Wastestream (Form DTSC ,Z 4 X 5 $ 100 a SEP C. Conditionally Authorized (Form DTSC 1 72C) Toy $1,140 D. Permit by Rule (Form DTSC 17AR) SIMSJ $1,140 = Accountin4 1 Total Number of Units Total Fee Attached $ 100.00 D. GENERATOR IDENTIFICATION EPA ID NUMBER CA C 0 0 0 0 6 6 9 5 7 BOE NUMBER (if available) HA HQ_3_�k 1 Q 2_0_1-5- NAME (Company or Facility) Heinz, U.S.A. (DBA—Doing Business Aa) PHYSICAL LOCATION 2800 South California Street For DTSC Use Only CITY Stockton CA ZIP 95206 Region COUNTY CONTACT PERSON Kurt Brause PHONE NUMBER 2( 09 ) 948 -2782 (First Name) (Ian Name) DTSC 1772 (1/93) Page I