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VI. CERTIFICATIONS: This form must be signed by an authorized corporate officer <br /> or any other person in the company who has operational control and performs decision making <br /> functions that govern operation ofthefacility(per California Code of Regulations(CCR), Title 22 <br /> section 66270.11). <br /> I certify under penalty of law that this document and all attachments were <br /> prepared under my direction or supervision in accordance with a system designed <br /> 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, <br /> or those directly responsible for gathering the information,the information is to <br /> the best of my knowledge and belief, true, accurate, and complete. I am aware <br /> that there are significant penalties for submitting false information, including the <br /> possibility of fine and imprisonment for knowing violations. <br /> Owner/Operator Signature Date Signed <br /> (Type or print)Name, and Title <br /> EPA ID Number <br />