[Comment: For dates of non-regulatory government publications, publications of recognized organizations and associations, federal rules, and federal statutory provisions referenced in this rule, see paragraph (FF) of rule 3745-100-01 of the Administrative Code titled "Referenced materials."]
(A) Availability of the alternate threshold certification statement and instructions. Availability of the alternate threshold certification statement and instructions is the same as provided in rule 3745-100-11 of the Administrative Code for availability of the reporting form and instructions.
(B) Alternate threshold certification statement elements. The following information shall be reported on an alternate threshold certification statement pursuant to rule 3745-100-14 of the Administrative Code:
(1) Reporting year.
(2) An indication of whether the chemical identified is being claimed as trade secret.
(3) Chemical name and chemical abstract number (CAS) (if applicable) of the chemical, or the category name.
(4) Signature of a senior management official certifying the following: "I hereby certify that to the best of my knowledge and belief for the toxic chemical listed in this statement, the annual reportable amount, as defined in paragraph (A) of rule 3745-100-14 of the Administrative Code, did not exceed five hundred pounds for this reporting year and that the chemical was manufactured, or processed, or otherwise used in an amount not exceeding one million pounds during this reporting year."
(5) Date signed.
(6) Facility name and address.
(7) Mailing address of the facility if different than paragraph (B)(6) of this rule.
(8) Toxic chemical release inventory facility identification number if known.
(9) Name and telephone number of a technical contact.
(10) The four-digit SIC code for the facility or establishments in the facility until the reporting year ending December 31, 2005, for which reporting forms are due July 1, 2006. Beginning with the reporting year ending December 31, 2006, for which reporting forms are due July 1, 2007, and for each subsequent reporting year, the six-digit NAICS code for the facility or establishments in the facility.
(11) Dunn and Bradstreet number of the facility.
(12) Name of the facility's parent company.
(13) Parent company's Dunn and Bradstreet number.
Five Year Review (FYR) Dates: 10/20/2016 and 02/11/2022
Promulgated Under: 119.03
Statutory Authority: 3751.02
Rule Amplifies: 3751.03
Prior Effective Dates: 5/07/2001, 01/16/2006, 09/25/2008, 11/4/2011