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STATE OF CALIFORNIA GOVERNOR'S OFFICE OF EMERGENCY SERVICES <br /> CALIFORNIA ACCIDENTAL RELEASE PREVENTION <br /> PROGRAM REGISTRATION <br /> OE5 2735.6(NEW(3197) PAGE 1 OF <br /> WT 3Q OR 1 <br /> REGISTRATION TYPE UPDA7E TYPE <br /> Read instructions on reverse before completing. NEW 171 UPDATE ❑ ADD E DELETE [j REVISE <br /> 1. Business Owner/Operator Information <br /> BUSINESS NAME <br /> US Chemical, a division of Hydrite Chemical Co. <br /> ADDRESS (NumberandStreer) <br /> 1448 Shaw Road <br /> CI7Y COUNTY STATE ZIP CODE <br /> Stockton San Joaquin CA 95215 <br /> OWNERIOPERATOR NAME PHONE NUMBER <br /> 414-792-1450 <br /> II. Regulated Substance List <br /> Process Max. <br /> A. Name of Each Regulated Substance Quantity (lbs) CAS# <br /> 1. This location is no longer owned or operated by US Chemical. <br /> 2. <br /> 4, <br /> 5. <br /> 6. <br /> 7. <br /> Percent Process Max. OAS# <br /> B. Name of Each Regulated Substance in a Mixture Weight Quantity(Ibs) <br /> 1. <br /> 111. Certification <br /> I, the owner or operator of the aforementioned business, hereby certify that the registration information provided <br /> above is true, accurate, and complete to the best of my knowledge, based upon reasonable inquiry. 1 am fully aware <br /> that this certification, executed on the date indicated below, is made under penalty of perjury under the laws of the <br /> State of California. <br /> OWNERIOPERATOR NAME(PRINT) <br /> Mark D. Laehn V.F./General Manager <br /> OWNER;OPERATOR SIGNATURE /. DATE EX- UTED <br />