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Mar 12 02 09: 13a ELEMENTS By Grapevine (209) 727-3716 p. e <br /> Mar 07 02 02i24p San �,quin OES 209-46 600 p. 2 <br /> RECSWD <br /> GMJ0A"G0UN1Y <br /> e&, <br /> COUNTY OF SANJOAQUIN )MOFEMERBENCYSERNES <br /> OFFICE OF ENMROENCY SERVICES RONALD e.e.uowl\'ROOM 610,t'OURTHOUSE ouaEcroaor <br /> 222 EAST WFSER AVENUE Eb�t'aOt1�C�OrtMT10NS <br /> STOCKTON,CALIFORNIA 95202 <br /> TELEPHVNF(?09)408.3%.' <br /> IIAZARDOUS MA'I'LRIALS DIVISION(ZW)464 3969 <br /> 2002 HAZARDOUS MATERIALS MANAGEMENT PLANANVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page,IINIMP. Unstaffed racility Network-Attachment,and Facility <br /> Map - Check one box only <br /> A. lz I certify (liar there(lave licca 1151 Oidngcs tv die above listed documents 51ncc <br /> our business's last update or change was submitted. <br /> B. Q 1 certify that their has been a change to one or more of the above documents <br /> and that either l)appropriate revised hard copy forms,or 2)a complete revised <br /> electronic copy of our Business ID Page/HMMP(HM1v1P97.FP3 File)and, if <br /> appropriate,our Unstaffed Attache nts(STAPF97.FP3 File)hasthave been <br /> transmitted concurrently with this Certification Statement, <br /> 2. Chemical Inventory (Chemical Descnption Page)- Chech one box only <br /> A. 1� 1 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 /> 13. U I certify that therehats been a change in vur chemical inventory since the last <br /> chemical inventory was submitted and githa 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 Tile)has been transmitted with this Statement. <br /> 3. Environmental,Contact E-Mail,.AdaB:,ss(if available) E1Cme1LTSr1V (1Q1 LOM <br /> I understand that falselinaeeurate information may make uty company liable In in emergency. I <br /> further certify that I have reviewed the above listed documents and information contained In the <br /> most recently submitted elsemiral inventory and have ensured that it meets the requirements of <br /> California Health and Safety Code, Chapter 6.95, Articles 1. <br /> Business Name_EIeMeNTS 6q la� }'. ✓VINE, —(-1yGOF$ Account a 77Sk <br /> Site Address 1OZJ1 Ntc,hw� p <br /> ./CO b <br /> LocKerolzu, ca. 95x37 ._.. <br /> FacilityOpera[or/Owner GL�SEn 'DE SANT IA6o Tido PI41vT MWNArPz_ <br /> Signawrc�CudtL_Kf gam, '�OQb' ,.�, Dam �� 6Z <br />