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Sme of CrSifrrti-a-'.,4fornia Ertrirowmenta[Aoaction Agency Departmot of Toxic Subwancea Control <br /> CERTIF-,CATION OF FINANCIAL ASroRANCE <br /> /rOR PERMIT BY RULE AND CONDITION Y AUTHORIZED OPERATIONS <br /> (See Aanrhed fw<ourmRr) <br /> FOR OFFICIAL USE ONLY O ((l•'S� 1 1` Ra1V�p gV': <br /> DISC REGIONAL OFFICE_ I /' I) Hazardous Waste Ma�a9�asnt <br /> For use by owner or operator of transportable treatmen unit, owner or operator of fize4 treatplenzvt <br /> Pe t <br /> by Rule, or a generat,r operating pursuant to a grant of Conditional Authorization. I <br /> O <br /> SU9 ,,, <br /> ® Initial Certification ❑ Amended Certification Certification <br /> Put on asterisk in the kft margin nt a to the amended information. <br /> I. GENERAL INFORMATION <br /> A. TYPE OF OPERATION: <br /> ® PBR-FTU ❑ PBR-TTU ❑ CA ❑ OTHER <br /> If operation is a ITU, insert TTU serial number: <br /> B. FACILITY/ITU EPA ID NO: C L4-D O � 7 Yq <br /> C. FACILITY/PTU NAME: E 1 6 M 4 e i IZ e'a ITS X—iva , <br /> M p}-( N S 1 TL- <br /> D. ADDRESS OR LEGAL DESCRIPTION OF FACILr:Y/TTU LOCATION: <br /> CISD Wi f2EMUOF Srn T <br /> CITY: S I'Z�C KTZ^!�/ CA ZIP CODE: S 2 03 <br /> COUNTY: 5A-r\f �TU 60 <br /> E. MAILING ADDRESS: <br /> CITY: S 7-VP-k72!W STATE: 9!� ZIP CODE: g -�- ZO3 <br /> F. CONTACT PERSON: <br /> ef+o LSCM �4-)eR-y <br /> LAST NAME FIRST NAME <br /> TELEPHONE NUMBERoZr 09 ) ` i6-3607 <br /> DTSC 1232 (8/96)Formerly 9113 (1/96) PAGE I OF 3 <br />