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Ay,N COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES RONALDE.BALDWIN <br /> _� •.iDIRECTOR OF <br /> ROOM 610,COURTHOUSE p��-� R�q <br /> 222 EAST WEBER AVENUE EM•p�;t6.eL � <br /> �+ r STOCKTON,CALIFORNIA 95202 nn <br /> �TP6F? <br /> TELEPHONE(209)468-3962 Uth 1 0 2001 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> 2002 HAZARDOUS MATERIALS MANAGEMENT PLAN/VROO SERVICES <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page HMMP Unstaffed Facility Network Attachment. and Facility <br /> Map - Check one box only <br /> A. 131. I certify that there have been no changes to the above listed documents since <br /> our business's last update or change was submitted. <br /> B. ❑ I certify that there has been a change to one or more of the above documents <br /> and that either 1) appropriate revised hard copy forms, or 2) a complete revised <br /> electronic copy of our Business ID Page&E"P (HIvIMP97.FP3 File) and,if <br /> appropriate, our Unstaffed Attachments (STAFF97.FP3 File) has/have been <br /> transmitted concurrently with this Certification Statement. <br /> 2. Chemical Inventory (Chemical Description Page) - Check one box only <br /> A. fel I certify that the information contained in the most recently submitted chemical <br /> inventory is complete, accurate, up-to-date, and contains the information <br /> required by Section 11022 of Title 42 of the United States Code. I further <br /> certify that there has been no change in the quantity of any hazardous material <br /> reported and that no hazardous materials are being handled that are not listed. <br /> B. ❑ I certify that there has been a change in our chemical inventory since the last <br /> chemical inventory was submitted and either 1)completed hard copies of <br /> Chemical Description Pages with "Add", "Delete", or"Revised"marked <br /> appropriately,or 2) a complete revised electronic copy of our chemical <br /> inventory (CHEM97 File) has been transmitted with this Statement. <br /> 3. Environmental Contact E-Mail Address (if available) <br /> I understand that false/inaccurate information may make my company liable in an emergency. I <br /> further certify that I have reviewed the above listed documents and information contained in the <br /> most recently submitted chemical inventory and have ensured that it meets the requirements of <br /> California Health and Safety Code, Chapter 6.95, Article 1. <br /> Cr16 <br /> Business Name nrLK-e— OESAccount # 9.0/6756;"( <br /> Site Address 7 0u14-o" A v2 <br /> Facility Operator/Owner# - l' 'ft) <br /> cpS - —Title— !) t.C?�i_ Ii <br /> (PRINT) <br /> Signature Date -7 c, 1 <br />