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—�,—JAN-08-'98 THU 08:59 J" TESORO .. TEL NO:209-464-7066 4629 P08 <br /> fdGlirortda4Uforola BavboammnlPmtedlon.�r� '"�uof Th k Coaaot <br /> CERTIFICATION OF FINANCIAL ASSURANCE <br /> FOR PERMIT BY RULE AND CONDITIONALLY AUTHORIZED OPERATIONS <br /> - (Se[AaraeAee Iarovao,.:) <br /> FOR OMCIAL LIM ONLY <br /> 1)1'SC REGIONAL OMCP_ <br /> i <br /> For use by owner or operator of transportable treatment unit,owner or operator of fixed treatment unit operating under Permit <br /> 3y Rule, or a generator operating pursuant to a grant of Conditional Authorization. <br /> i <br /> ❑ Initial Certification ❑ Amended Certification ❑ Annual Certification <br /> Put an asterisk in the left margin next to the amended information. <br /> ' GENERAL INFORMATION <br /> A. TYPE OF OPERATION: <br /> ❑ PBR-FTU ❑ PBR-TTU ❑ CA ❑ OTHER <br /> If operation is a TTU, Insert TTU serial number: <br /> B. FACHdTYf= EPA ID NO: <br /> C. FACILITY=NAME: <br /> I <br /> D. ADDRESS OR LEGAL DESCRIPTION OF FACHdTYieM LOCATION: <br /> CITY: CA Ze CODE: <br /> COUNTY: <br /> E. MAILING ADDRESS: <br /> CITY: STATE: ZIP CODE: <br /> F. CONTACT PERSON: <br /> LAST NAME - FoWr NAME - <br /> TELEPHONE NUMBER ( ) - <br /> i <br /> I TSC 1232(8196)Formerly 8113(1196) PAGE 1 OF 3 <br />