Laserfiche WebLink
COUNTY OF SAN JOAQUIN <br /> r; = OFFICE OF EMERGENCY SERVICES R4 AALLDLsALDWIN <br /> ROOM 610,COURTHOUSE D ct6LSbRgyUrAl5SR 0 <br /> 222 EAST WEBER AVENUE l% <br /> ��•:.,... i� STOCKTON,CALIFORNIA 95202 D <br /> 4so'w� <br /> TELEPHONE(209)468-3962 DEC t $ <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> 1999 HAZARDOUS MATERIALS MANAGEMENT PLAN/INF� �wm <br /> CERTIFICATION STATEMENT crSE <br /> 1. Business Identification Page. HMMP Unstaffed Facility Network Attachment and Facility <br /> Map - Check one box only. <br /> A. ❑ 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/HMMP (HMMP97.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 Pagel Check Box A or B <br /> A. ❑ 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 /> Y1t� B. I certify that there has been a change in our chemical inventory since the last <br /> IAO'dv � l (�� chemical inventory was submitted and either 1) completed hard copies of <br /> �/t2 Chemical Description Pages with"Add", "Delete", or"Revised" marked <br /> co appropriately, or 2) a complete revised electronic copy of our chemical <br /> c4rix inventory (CHEM97.FP3 File) has been transmitted concurrently with this <br /> Certification Statement. <br /> 3. Environmental Contact E-Mail Address (if available)• <br /> I understand that false/S �acccurate information may /m,�ake my company liable in an emergency. <br /> Business Name /Y/ t: n'7/ (� /�1�-f' <br /> Site Address �� WVY l / /h 99/yd <br /> Facility Operator/Owner / Y'f�i Y17G Title G 1 <br /> Signature �h Date <br /> We, Q��� C� <br /> P�J2rl Clk� <br />