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JAN-08-'98 THU 08:59 ESORO TEL N0:209-6- X66 #629 P08 <br /> !•dC�Iltom4L(`lUotdaSnvLomlet�Iptvituti nAS-W WpumnntofTOXIC CoubW <br /> CERTIFICATION OF FINANCIAL ASSURANCE <br /> FOR PERMIT BY RULE AND CONDITIONALLY AUTHORIZED OPERATIONS <br /> i (See Aaaehed Zw&uctio+.r) <br /> FOA OFFICIAL.USE ONLY <br /> DISC MCIONAL OFFICE_ <br /> i <br /> For use by owner or operator of transportable treatment unit,owner or operator of fixed treatment unit operating under Permit <br /> ay Rule, or a generator operating purstlaut to a grant of Conditional Authori2ation. <br /> i <br /> ❑ Initial Certification ❑ Amended Certification ❑ Annual Certification <br /> Put an arterisk in the kft margin nett to the amended infortnation. <br /> J ` GENERAL INFORMATION <br /> A. TYPE OF OPERATION: <br /> ❑ PBR-FTU ❑ PBR-TTU ❑ CA ❑ OTHER <br /> If operation is it ITU, Insert TTU serial number: <br /> B. FACILITY/ITU EPA ID NO: <br /> C. FACILITY/TTU NAME: <br /> I <br /> D. ADDRESS OR LEGAL DESCRIPTION OF FACHdTT/TPU LOCATION: <br /> CITY: CA ZIP CODE: <br /> COUNTY: <br /> E. MAILING ADDRESS: <br /> CITY: STATE: ZIP CODE: <br /> F. CONTACT PERSON: <br /> LAST NAME F1RSr NAME - <br /> TELEPHONE NUMBER <br /> TSC 1232(St%)Formerly 8113(1196) PAGE I OF 3 <br />