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EPA ID NUMBER: CAD983635038 FACH.ITY NAME: OUALEX INC/MANTECA INFORMATION STATUS: The information in the Notification Renewal Form is: ❑ 1. Unchanged and correct. © 2. Incorrect and has been corrected. ❑ 3. Amended to reflect operational changes of the facility which have occurred since the last notification (include attachments if applicable). Note: If adding new treatment units use the Unit Specific Forms(1772B, C, D or L) and attach with your PBR renewal form. CERTIFICATION. This form must be signed by an authorized corporate officer or any other person in the company who has operational control and performs decision-making functions that govern operation of the facility (per Title 22, California Code of Regulations (CCR) Section 66270.11). Waste Minimization I certify that I have a program in place to reduce the volume, quantity, and toxicity of waste generated to the degree I have determined to be economically practicable and that I have selected the practicable method of treatment, storage, or disposal currently available to me which minimizes the present and future threat to human health and the environment. Tiered Permitting Certification I certify that the unit or units described in these documents meet the eligibility and operating requirements of state statutes and regulations for the indicated permitting tier, including generator and secondary containment requirements. I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those directly responsible for gathering the information, the information is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are substantial penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations.Name (Print or Type) Title (Print) z - I - 97 Si atnre Date Signed r., REQUESTING A SHORTENED REVIEW PERIOD: YES ❑ Reason: Unit Name : _.a SUBMISSION PROCEDURES: One coli with original signature to DTSC and one copy to your local CUPA or county agency. MAIL TO: Department of Toxic Substances Control Your Local CUPA or County ATTN. PBR RENEWAL - Tiered Permitting Agency P.O. Box 806 (Listing attached.) Sacramento, CA 95812-0806 You must also retain a copy as part of your operating record.