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03/07/97 ONSITE HAZARDOUS WASTE TREATMENT Page: 2 <br /> NOTIFICATION RENEWAL FORM CAD980893184 <br /> Note: A 'U' on a question line indicates that you did not provide an answer <br /> on your application. Please change it to a Yes or No <br /> III. RADIOACTIVE MATERIALS OR WASTE - Specify Yes or No <br /> N Does this facility use, store or treat radioactive <br /> -- materials or radioactive waste? <br /> IV. TYPE OF COMPANY: STANDARD INDUSTRIAL CLASSIFICATION (SIC) CODE: <br /> First: 3672 Printed circuit boards <br /> ---- ------------------------------------------------ <br /> Second: 0000 <br /> ---- ------------------------------------------------ <br /> V. PRIOR PERMIT STATUS: Specify Yes or No <br /> Y 1. Did you file a PBR Notice of Intent to Operate for this <br /> -- location? <br /> N 2. Do you now have or have you ever held a state or federal. <br /> -- hazardous waste facility full permit or interim status for any of <br /> these treatment units? <br /> N 3. Do you now have or have you ever held a state or federal full <br /> -- permit or interim status for any other hazardous waste activities <br /> at this location? <br /> N 4. Have you ever held a variance issued by the Department of Toxic <br /> -- Substances Control for the treatment you are now notifying for at <br /> this location? <br /> Y 5. Has this location ever been inspected by the state or any local <br /> -- agency as a hazardous waste generator? <br /> VI. PRIOR ENFORCEMENT HISTORY - Specify Yes or No <br /> N Within the last three years, has this facility been the subject of <br /> -- any convictions, judgments, settlements, or final orders resulting <br /> from an action by any local, state, or federal environmental, <br /> hazardous waste, or public health enforcement agency? <br /> VII. ATTACHMENTS SUBMITTED: <br /> X A plot plan/map detailing the location(s) of the covered unit(s) <br /> -- in relation to the facility boundaries. <br /> X A unit specific notification form for each unit to be covered at <br /> -- this location. <br /> VIII. CERTIFICATION: <br /> $1'6.A 01S'y4.gLrd <br /> Nom; TITLE: OPERATIONS MANAGER <br />