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Below is an example of a completed on- screen materials balance report for a single chemical. <br />r <br />FORMALDEHYDE <br />I IM I I 0"050 Y55T.IJ <br />k. , , 2,011 " rXI W AB 4', raima��c,•n <br />it r III zYl Y 61 -iY Pd l s ^: I+V <br />JAN I Aam^mow'" I7 <br />jAVa n wvdw., r=(2V - aw5 faYYaJ ' <br />pwnrn�ciJm.cvr 1`dM, Inv ,,,,,,,_..,,4(7.5.11 <br />(3j ON <br />& A,r U w w T �4ji x <br />Ton of hwvm 115-61"o-o" <br />I 1 <br />1 1 1311000 <br />C'aTAn. m Curl A�n <br />to I vrrcametp P,..a,d Wd,� On 4a . d''lov. <br />On page 36 is an example of the certification form that is to be executed by each reporting <br />company and submitted to the City along with the electronic materials balance report each year. <br />Page 37 is a suggested worksheet that companies may use to assist them in documenting <br />chemical use and calculation methodology. This worksheet is not required, but businesses are <br />expected to produce adequate documentation when their reports are audited. <br />-35 - <br />"JR?CA <br />......... � <br />FFAC,W ASRFAH �'YrIEiLE SE ......... <br />...._ Gf�kY <br />az <br />15P:l <br />..,.,. . Sh1pf7 <br />ErvwA �w NPIS�c.�urlaa �S� � .................... <br />fifkl� <br />.6,65 <br />.. a <br />O (Vlv9 <br />51 pti ......... <br />bb f ob <br />rie" 31 Wvr vreywt l) ........... <br />r iu m66 <br />1 1 1311000 <br />C'aTAn. m Curl A�n <br />to I vrrcametp P,..a,d Wd,� On 4a . d''lov. <br />On page 36 is an example of the certification form that is to be executed by each reporting <br />company and submitted to the City along with the electronic materials balance report each year. <br />Page 37 is a suggested worksheet that companies may use to assist them in documenting <br />chemical use and calculation methodology. This worksheet is not required, but businesses are <br />expected to produce adequate documentation when their reports are audited. <br />-35 - <br />