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Jul 01 99 03: 28p In DeAngelis 2 468-4730 p. 5 �G so aa.aa. oar+ Own ZOt :s 209-460 4730 P.'•, Nu ME CERTIFICATIONS: 77tis form must be signed by an Jurhotited corporate of5cv or on.. other perms to the ct nrpor' har opemt:anal control and performs dreisson-making fumaions that govern operation of r.he faci1try(per Title 72.CeG r;r;ri_ Crede of Reguiariont iCCR)Section 6627x,11). 411 three copies mass have original signatures. Wa;(g,�& alae fon 1 certify that I have a program in pingo to reduce the volume,quantcty,and toxicity of waste generated t„it,; dcgrcc 1 have deterrriincd to be economically practicable and:hat I have selected the practicable method of treatment. swiafe. disposai cunertly available to me which minimizes the present and future threat to human health acrd t`ie environment Tierce ercnittintt Certlflcation I cerlifY that the unit or -nits described in these documents tneu rhe eligibility and opts.l rnv rcquiretrrants of state statutes wad regulations for the indicated permitting tier, including generator and secondary contaiumcr.; requirements. 1 understand ghat if any of the units operate under Formol by Rule or Conditional Autt:otization, f will also the ieuuired financial ass iranee for closure of the treattrtenc unit by Ocrobcr 1, 1996. I txrify under penairy of taw that this document and ail attachments were prepared under my dirccr,on or supervision in acrartN;,e with a systerr. designed to ?sure :!tar aualifced personnel properly. gather and evaluate the information submitted. Based tin rt. inauiry of the person or pusens who-wage enc system,or those directly responsible for;athenng the information,the informxuar. is, to the bat of my knowledge and belief,true, accurate, and complete, I am aware that there are subsiziciaf penalties for submilti:g false information,including tk: possibiltty of fines and impnsonmer.t for knnowtn�b�violaaons, ,tel%G(r� 4f _ & /S1�Ann7�fY Name(Print err ypc) Tulc _ 0(. REQUESMG A SHORTENED REVIEW PERIOD: Gene),arors operating under CA andlar CE are tegatly nrfhorizen to operate 60 days after submiuing a complete noty1carton. DISC ma'y Shorten the tune period between nopf cation and ilklft nurthon when the owner or operator estabBshes good cause. of you need to be authorizers sooner than the standard 60 day period,please check the bnz below and state the reason. Your authorization will be ouimnaticalty effective on the date your completed noiOcanon form is recei ed by DISC. lute adQitianal sheet., If necessary; YES L._J Reason: OPFRATLNG REQUIREMENTS: Please note that generarori treating hazardous waste onsite are required 10,comply with a number of operating requsreinenif which differ depending on rite rier(5). These operaiin4 reaairernanu are.tel forth in the statutes and regitatioar, some of which .re- referenced in rhe Tier-Specific Foci Sheets cvadoble from DTSC's regionai and headquarters offices SUBMISSION PROCEDURES: Alt Mref forms must have art inn signatures, not photocopier. You must submit l)yo eoDirs of t1is completed notificauan b'., carrified mai! return receipt regvested,to: Department of Toxic Substances Control Program Data Management Section,HQ-10 Attn TP Notifications Form 1172 4a)P Street, 4th Floor,Room 4453(walk in ortiy) P 0 Boz 906 Sacramento, CA 95812-0806 You must also submit aiie egpy of the notification and atinchtnents to the local regulatory agency ir,four jutisd:ctioa as iwol in Appendix 2 of the instruction materials. You must also retain a copy as part of yow operaliag record. PLEASE, Do NOT S1';,\'U YOUR PEE'PAYMENT WITH TWS FORM. DT SZ 1772 i 1;401 Page