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EPA ID NUMBER C A L 9 2 3 4 2 4 2 31 Page3 e <br /> [ � T <br /> VIII. CERTIFICATIONS: This form must be signed by an authorized corporate officer or any other person in the Con""x <br /> has operationai control and performs decision maidng functions that gowern operation of the facility(per Title 22.Ca*or. <br /> Code of Reguiations (CCR) Section 66270.11). All di6rw copies retro have oa"iginal signaaam. <br /> Waste A4inimiation I certify that I have a program in place to reduce the volume. quantity, and toxicity of waste genernmg to <br /> degree I have determined to be economically practicable and that I bave selected the practicable method of treatment. stamps. <br /> disposal currently available to me which trimimizes the present and future thrcatt to bimun health and the envuMmeat. <br /> ic;ed Permitting cerfirication certify that the unit or units described is these documents meet the eligibility and apww <br /> roquirements of state statutes and regulations for the indicated permitting tier, including generator and secondary toataiam <br /> requirements. i understand that if any of the units operate under Permit by Rule or Conditional Authorization,I will also be tcgw <br /> to provide required financial assurance for closure of the treatment unit by January 1, 1995. <br /> I certify under penalty of law that this document and all attarhmmts were prepared under my direction or supervision is somodar <br /> with a system designed to assure that qualified personnel properly gather and evaluate the information submitted.Based on my' <br /> of the person or persons who manage the system, or those directly responsible for gathering the information.the mese is. <br /> the best of my imawledge and belief, true, accurate, and complete. <br /> I ata aware that there are substantial penalties for submitting false information, including the possibility of sae:cad imQtdsaaar <br /> for!mowing violations. <br /> Mice Wissei Quality Assurance Coordii►ato. <br /> Name (Print orT Title <br /> ;�� 41zl�0 08-30-95 <br /> Signature Date Signed <br /> OPERATING REQUIREMENTS: <br /> Plante note that generators treating hazardous waste onsite are required to comply with a number of operating mquirvnerru wh <br /> differ dqmuiwg on the nerfs). These operating te;gWr wmx are set forth in the statutes and regulations, sante of tulles <br /> referenced in the Ter-Specific Fact Sheets available front the Department's regional and headquarters gfat. <br /> SUBMISSION PROCEDURES: <br /> You must submit two mvier of this completed notification by terrified mail, return receipt requested. to.- <br /> Department <br /> o.Department of Toric Substances Control <br /> Program Data Management Section <br /> 400 P Street, 4th Floor, Room 4453 (walk in only) <br /> P.O. Boz" <br /> Saawnento, CA 95812-0806. <br /> You must also xu&-nir one nom+of the notification and anachmems to the local regulatory agency in your jurisdiction at lines <br /> Appendix 2 of the instruction materials. You mast also retain a copy as part of your operating record. <br /> 11 must have oririnal sigra urm, not photampim. <br /> DTSC 1772 (1/95) paq <br />