Laserfiche WebLink
' State of California-California Environme�?rotection A enc <br /> e artment of Toxic Substances Control <br /> UNIFIED PROGRAM CONSOLIDATED FORM HAZARDOUS WASTE <br /> ONSITE HAZARDOUS WASTE TREATMENT NOTMCATION - FACILITY PAGE <br /> Pa a of <br /> t <br /> BUSINESS NAME(Same as FACILITY NAME or DBA Doing Boniness As) <br /> 3 FACILITY IDN <br /> Silicon Timikey Solutions <br /> IL STATUS <br /> w. <br /> NOTIFICATION STATUS 600 PERMIT STATUS(Check all that apply) <br /> ®a Amended ®a Facility Permit ❑d Variance <br /> C3 Initial <br /> ❑b Interim Status ❑e Consent Agreement <br /> ❑c Renewal(PBR Only) ❑c Standardized Permit <br /> III. NUMBER OF UNITS AT FACILITY <br /> (Indicate the number of units you operate in each tler,attach one unit notification page for each unit except CE-0L) <br /> 602 <br /> A Conditionally Exempt—Small Quantity Treatment(CESQT)(May not function under any other tier) <br /> B Conditionally Exempt Specified Wastestream(CESW) <br /> C Conditionally Authorized(CA) <br /> OPermit by Rule(PBR) 01 <br /> E Conditionally Exempt—Limited(CEL) - <br /> F Conditionally Exempt Commercial Laundry(CE-CL) (No unit page is required for laundries) <br /> G TOTAL UNITS(Must equal the number of unit notification pages attached plus the number of CE-CL units) <br /> IV, CERTIFICATION AND SIGNATURE <br /> Waste Minimization I certify that I have a program in place to reduce the volume,quantity and toxicity of waste generated to the degrce I have detemtined to be <br /> economically practicable and that I have selected the practicable method of treatment,storage,or disposal currently available tome which minimizes the present and <br /> future threat to human health and the environment. <br /> Tiered Perim ine Certification I certify that the unit or units described in these documents meet the eligibility and operating requirements of state statutes and <br /> regulations for the indicated permitting tier,including generator and secondary containment requirements. I certify under penalty of law that this document and all <br /> attachments were prepared under my direction or supervision in accordance with a system designed to assure that qualified personnel properly gatber and evaluate the <br /> information submitted. Based on my inquiry of the person or persons who manage the system,or those directly responsible for gathering the information,the <br /> information is,to the best of my knowledge and belief,true,accurate,and complete. <br /> I am aware that there are substantial penalties for submitting false information,including the possibility of fines and imprisonment for knowing violations. 603 <br /> SIGN TURE FOWNER/OPERAT R DATE <br /> 5/13/04 <br /> NAME OFO <br /> TITLE OF OWNER/OPERATOR ms <br /> Zef Malik President <br /> REQUEST FOR SHORTENED REVIEW PERIOD(CE and CA only) ❑ Yes ❑ No <br /> State Reason for Request ` <br /> V.ATTACHMENTS(Check if attached) <br /> ALL tiers except CE-CL(Laundries)must submit: PBR ONLY <br /> ® 1 One unit specific notification page and one treatment process page per unit ❑ 1 Tank and container certifications,if required <br /> ® 2 Plot Plan(or other grid/map) ❑ 2 Notification of local agency or agencies <br /> ❑ 3 Notification of property owncr,if different from business owner <br /> PBR&CAONLY: <br /> ® 1 Closure Financial Assurance(formerly DTSC form 1232) <br /> ® Self Certified(<$10,000) ❑ Other mechanism <br /> ❑ 2 Prim Enforcement History,if applicable <br /> UPCF(12/99 revised) 20 Formerly DTSC 1772 <br />