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6. Compliance Verification Statement <br />I certify the truth, accuracy, and completeness of the information being submitted. The facility is it <br />compliance with all the relevant standards of 40 CPR Part 63, Subpart HHHHHH. <br />Signaturet. <br />Printed Name L' 4' 1� Title <br />Address . t `\ V ► Rv� �+ � na.s <br />City, State, Zip "iti »"`i ` CS <br />Telephone number —I ► % a- 0Email (if available) <br />Owner <br />I am the: <br />Date <br />Operator ❑ <br />-,- 14-\-�� <br />t ►.s 3'-- <br />7. Where to send the Completed Notification of Compliance. Status <br />Retain a copy for your records <br />If two addresses are listed <br />Indiana businesses <br />USEPA Region 5 <br />Compliance Tracker AE-17J <br />77 W Jackson Blvd <br />Chicago, IL 60604 <br />Certifying Official ❑ <br />for your state, send a copy to both addresses. <br />Michigan businesses <br />USEPA Region 5 <br />Compliance Tracker AE-17J <br />77 W Jackson Blvd <br />Chicago, iL 60604 <br />Minnesota businesses <br />USEPA Region 5 <br />Compliance Tracker AE-:17J <br />77 W Jackson Blvd <br />Chicago, IL 60604 <br />Wisconsin businesses <br />USEPA Region 5 <br />Compliance Tracker AE-17J <br />77 W Jackson Blvd <br />Chicago, IL 60604 <br />Notification of Compliance Status <br />DEM <br />Office of Air Quality <br />and Compliance and Enforcement Branch <br />100 North Senate Avenue <br />MC61-53, IGCN 1003 <br />Indianapolis, IN 46204-2251 <br />No State Submittal Required <br />No State Submittal Required <br />MACT Notifications <br />and WI DNR - Air Program AM/7 <br />PO Box 7921 <br />Madison, WI 53707-7921 <br />Page 3 of 3 <br />