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SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM RECEIVED <br /> SMJ0AQUIN CUUNR <br /> QFNEOFDt6ENCYSERKES <br /> DECLARATION OF COMPLETENESS AND ACCURACY <br /> I certify under penalty of law that I have personally reviewed the Hazardous Materials Management Plan <br /> and Inventory submitted by my business and have ensured,to the best of my knowledge, it meets the <br /> requirements of the California Health and Safety Code, Chapter 6.95, Article 1. I understand that <br /> false/inaccurate information may contribute to avoidable complications during a hazardous materials <br /> incident. <br /> oy , pl e4e 1VelJe/5 <br /> Name of Business <br /> Nu' d L v,-, d <br /> Name of Facility Operator/Owner <br /> Title of Facility Operator/Owner <br /> Signature (in ink) <br /> Date <br /> SJC 12/00 <br />