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RECEIVE® JAN 15 2002 COUNTY OF SAN JOAQUIN o Q uCOUNTY g$�nOES OFFICE OF EMERGENCY SERVICES ROOM 610,COURTHOUSE DIRECTOR OF N: 222 EAST WEBER AVENUE EMERGENCY OPERATIONS STOCKTON,CALIFORNIA 95202 TELEPHONE(209)468-3962 HAZARDOUS MATERIALS DIVISION(209)468-3969 2002 HAZARDOUS MATERIALS MANAGEMENT PLANANVENTORY CERTIFICATION STATEMENT (See Reverse Side for Instructions) 1. Business Identification Page HMMP Unstaffed Facility Network Attachment. and Facility Map - Check one box only A. ❑ I certify that there have been no changes to the above listed documents since our business's last update or change was submitted. B. I certify that there has been a change to one or more of the above documents and that either 1) appropriate revised hard copy forms, or 2) a complete revised electronic copy of our Business ID Page/H CvIP (HMMP97.FP3 File) and, if appropriate, our Unstaffed Attachments (STAFF97.FP3 File) has/have been transmitted concurrently with this Certification Statement. 2. Chemical Inventory (Chemical Description Page) - Check one box only A. I certify that the information contained in the most recently submitted chemical inventory is complete, accurate, up-to-date, and contains the information required by Section 11022 of Title 42 of the United States Code. I further certify that there has been no change in the quantity of any hazardous material reported and that no hazardous materials are being handled that are not listed. B. ❑ I certify that there has been a change in our chemical inventory since the last chemical inventory was submitted and either 1) completed hard copies of Chemical Description Pages with "Add", "Delete", or"Revised" marked appropriately, or 2) a complete revised electronic copy of our chemical inventory (CHEM97 File) has been transmitted with this Statement. 3. Environmental Contact E-Mail Address (if available) �V 1uI I lW 4 WI LM I understand that false/inaccurate information may make my company liable in an emergency. I further certify that I have reviewed the above listed documents and information contained in the most recently submitted chemical inventory and have ensured that it meets the requirements of California Health and ��Safety Code, Chapter f/�6.9955,,�{Article 1. Business Name ' I'Vll�4:l.— 1,-t1-,,qu-s- Lf[ /✓'fGTq�(/y�� w I /y y�- Q'O�EjS Account it Site Address 14 1 E • PAmm w 41 -� I1,1_ tl MN l '�f c 1" i'Zl() Facility Operator/Owner IS C �i` _TideY Sko re w e i Ag L PAINT) Signature Date