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Suaue a California - Cassia F�.iroommtat ! cd" Aamy Deparmaot of Tmrk Sobetaocae Casual 765£-6 page 1 �� ONSITE HAZARDOUS WASTE TREATMENT NOTIFICATION FORM : FACILITY SPECIFIC NO-1 FICA-60h.1 2: C'5 For Use by Hazardous Waste Generators Performing Treatment ❑ Initial '1 j Under Conditions! Exemption and Conditional Authorization, ® Revised u and by Permit By Rule Facilities Please refer to the attached Instructions before completing this form. You may not for more than one permitting tier by using this norii ication form, DISC 1772. You must attach a separate unit spedflc notiffcatlon font[for each unit at this location. There are different unit specifc notification forms for each of the four categories and an additional not fcatlon form for transportable treatment units (7711s). You only have to submit forms for the tier(s) that cover your unft(s). Discord or recycle the other unused forms, Number each page of your completed not f cation package and indicate the total number of pager at the top of each page at the Pageof—'. Put your EPA ID Number on each page. Please provide all of the information requested.- allfieldr must be completed except those that state 'if different' or 'if available'. Please type the information provided on this form and any attachments. .. . .. . .. . - -- --- ---- - ---- ------- . The not f cation will not be considered complete without payment of the appropriate fee for each tier under which you are operating. (Please note that rhe fee is per 77ER not per UNIT. For example, if you operate S units but they are all CondltlonaUy Autliorimd, you only owe$1,140, NOTS tines$1,140L If you operate any Permit by Rule units and any units under CottdU7onalAtahoriuhrion you owe$2,280.) Checks should be made payable to the Department of Toric Subsianaes Control and be stapled to the top-of dai form Please write your EPA ID Number on the check Fill In the check number In the bar above. - L NOTIFICATION CATEGORIES Indicate the number of units you operate In each tier. This will also be the number ofunit spedfic noNficddio forms you must attach. Condltional7y Exempt Small Quantity D -eatrnent operations may not operate unitr undo any other tier. Number of units and attached unit specific notifications Fee Per Tkr A. 0 Conditionally Exempt-Small Quantity Treatment (Form DTSC 1772A) $ 100 B. 1 Conditionally Exempt-Specified Wastestrearn (Form DTSC 1772B) y $ 100 C. _ 0 Conditionally Authorized (Form DTSC 1772C) $1,140 X D. 0 Permit by Rule (Form DTSC 1772D) $1,140 a s a a a assaasas t, i Total Number of Units Total Fee Attached $ 100. 00 11. GENERATOR IDENTIFICATION EPA ID NUMBER CA L 0 0 0 0 3 2 2 7 1 BOE NUMBER (if available) HA HQ 3 6 0 3 5 7 9 4 NAME (Company or Facility) San Joaquin Cogen (DBA-Doing Busimis As) PHYSICAL LOCATION c/o Destec Operating Company (Operator) 17200 South Harlan Rd. Fce DTSC U"Dolt CITY Lathrop CA ZIP 95330 COUNTY San Joaquin CONTACT PERSON Rim Meyer PHONE NUMBER(209)858 • 5129 (Fret Neme) (La Name)