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ii A Notice of Intent for General WDRs Order No. R5-2008-0149 - 2 - IN-SITU GROUNDWATERREMEDIATION AT SITES WITH VOLATILE ORGANIC COMPOUNDS, 11 NITROGEN COMPOUNDS, PERCHLORATE, PESTICIDES, SEMI-VOLATILE COMPOUNDS AND/OR PETROLEUM HYDROCARBONS !� 6. CALIFORNIA ENVIRONMENTAL QUALITY ACT CEQA Has a CEQA determination been made by an Name of agency: agency. ❑ Yes ❑ No Type of Determination: Date of Determination: If the CEQA determination was made after the date of adoption of this General WDR, then include a copy of the CEQA determination with this NO]. 7. PROCESS ❑ Single-Injection Points ❑ Continuous Injection ❑ Recirculation System Amendments to be added: Volumes of Amendments per Month: Storage on Site? ❑ Yes ❑ No Pollutants to be treated: Rates of amendment additions: Max rate of amendment addition: Extraction and Injection Rates (give units) Treatment Methods and flows (give units): Average: Maximum: Average: Maximum: 8. WASTES GENERATED Check All That Apply: ❑ Treatment Wastewater ❑ Domestic Wastewater (separate system) ❑ Stormwater ❑ Solid waste - Type 9. AMENDMENTSTORAGE Describe the type(s) of storage vessels, including capacity of each, that will be used to store amendments: How will liquid be stored and monitored to prevent spillage? 10. CERTIFICATION "I certify under penalty of law that this document and all attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the information submitted. Based on my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the information, the information submitted is, to the best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting false information, including the possibility of fine and imprisonment for knowing violations." Print Name: Title: Signature: Date: AMM: 25 September 2008 r±f