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Tiered Permitting: Facility <br /> California Environmental Reporting System (CERS) <br /> r�< <br /> acility/Si ;: ,. � CERS ID <br /> µ <br /> ynergy Health 10184097 <br /> 801 LONGE ST <br /> TOCKTON,CA 95206 — <br /> ubmittal Status <br /> ubmitted on 4/15/2014 by Brion Hanson of Synergy Health(Stockton,CA) <br /> ubmittal was Accepted;Processed on 4/17/2014 by Elena Monza for San Joaquin County Environmental Health <br /> permit Status umber of Units at Facility <br /> Facility Permit g Unit Type/Tier <br /> 0 Conditionally Exempt-Small Quantity Treatment(CESQT) <br /> Interim Status <br /> 0 Conditionally Exempt Specified Wastestream(CESW) <br /> Standardized Permit 0 Conditionally Authorized(CA) <br /> 0 Permit by Rule(PBR) <br /> Variance <br /> 0 Conditionally Exempt-Limited(CEL) <br /> Consent Agreement 1 Number of CE-CL Units <br /> 1 TOTAL UNITS <br /> Certification <br /> Waste Minimization I certify that I have a program in place to reduce the volume,quantity and toxicity of waste generated to the degree I have determined to be economically <br /> practicable and that I have selected the practicable method of treatment,storage,or disposal currently available to me which minimizes the present and future threat to human health <br /> and the environment. <br /> Bred Permitting Certification I certify that the unit or units described in these documents meet the eligibility and operating requirements of state statutes and regulations for the <br /> Indicated permitting tier,Including generator and secondary containment requirements.I certify under penalty of law that this document and all attachments were prepared under my <br /> 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 <br /> person or persons who manage the system,or those directly responsible for gathering the information,the Information is,to the bast of my knowledge and belief,true,accurate,and <br /> complete. <br /> I am aware that there are substantial penalties for submitting false Information,Including the possibility of fines and imprisonment for knowing violations. <br /> Owner/operator Name Date Certified Request for Shortened Review Period(CE and CA only) <br /> Brian Hanson 4/15/2014 <br /> Owner/Operator Title <br /> Maintenance Team Lead <br /> F I.me <br /> E C"" E I V E <br /> MAY 0 7 2014 <br /> ENVIRONMENTAL HEALTH <br /> DEPARTMENT <br /> Printed on 5/7/2014 11:57 AM <br />