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EPA ID Number I C I A I R 1 0 1 0 1 0 1 2 1 2 1 9 1 7 1 3 1 2 OMB#2050-0024; Expires 05/31/2020 <br /> 18. Comments (include item number for each comment) <br /> Short-Term Notes <br /> Notes <br /> 19. Certification I certify under penalty of law that this document and all attachments were prepared under my direction or su- <br /> pervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information <br /> submitted. Based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gath- <br /> ering the information,the information submitted is,to the best of my knowledge and belief,true, accurate,and complete. I am <br /> aware that there are significant penalties for submitting false information, including the possibility of fines and imprisonment for <br /> knowing violations. Note:For the RCRA Hazardous Waste Part A permit Application,all owners and operators must sign(see 40 <br /> CFR 270.10(b)and 270.11). <br /> Signature of legal owner,operator or authorized representative Date(mm/dd/yyyy) <br /> 03/01/2018 <br /> Printed Name(First, Middle Initial Last) Title <br /> Charles Savage egulatory Compliance Specialist 2 <br /> Email <br /> csavage@verisk3e.com <br /> Signature of legal owner,operator or authorized representative Date(mm/dd/yyyy) <br /> Printed Name(First, Middle Initial Last) Title <br /> Email <br /> EPA Form 8700-12,8700-13 A/B,8700-23 SI Page 6/6 <br />