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4/30/2019 Electronic Signature Agreement 2- <br /> (9) <br /> (9) Agree to contact the CDX Help Desk if I do not receive an e mail notification within 5 business days for any <br /> electronically signed submission using my credentials. <br /> (10) Agree to report, within 24 hours of discovery, any evidence of discrepancy between any electronic <br /> document I have signed and submitted and what the CDX has received from me by contacting the CDX or <br /> service Help Desk. <br /> (11) Agree to notify the EPA if I cease to represent the regulated entity specified above as signatory of that <br /> organization's electronic submissions by contacting the CDX Help Desk as soon as this change in relationship <br /> occurs and to sign a surrender certification at that time_ <br /> (12) Agree to retain a copy of this signed agreement as long as I continue to represent the regulated entity <br /> specified above as signatory of the company's electronic submissions. <br /> (13) Certify I have the authority to enter into this Agreement on behalf of the Organization identified above, and <br /> I am a signatory authorized to represent that Organization, and I am able to sign and submit reports and other <br /> information on behalf of that Organization in the capacity required by statute and/or regulation. <br /> (14) Certify that by signing and submitting this agreement,I have read, understand, and accept the terms and <br /> conditions of this electronic signature agreement. I certify under penalty of law that I have personally examined <br /> and am familiar with the information submitted in this agreement and I believe that the information is true, <br /> accurate and complete. I am aware that there are significant penalties for submitting false information, including <br /> the possibility of fine and imprisonment. <br /> Name of electronic signature holder: Elena K Seymour-Heiner <br /> Signature: <br /> Date: <br /> 111-30111 <br /> PLEASE SEND THIS DOCUMENT AS SOON AS POSSIBLE TO: <br /> Notifications -myRCRAid <br /> CA DTSC <br /> 1001 1 Street <br /> 11th Floor <br /> Sacramento, CA 95814 <br /> 800-618-6942 <br /> https://rcrainfo.epa.gov/rerainfoprod/action/industry/secured/unauthorized/esa#!/verify-identity 2/2 <br />