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SAN JOAQUINARDOUS OFFICE <br /> MATEOF <br /> PROGRAM SERVICES <br /> HAZRECEIVED <br /> SA"AUUINGUUNTY <br /> 0.,E OF EMERGENCY SERVIC ES <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. 1 <br /> 1 <br /> q�� JRCK 1 N Tk1� 8�X # 5loS <br /> Name of Business <br /> �Nll. YR'DAV <br /> Name of Facility Operator/Owner <br /> KC-S i Dc-Nr <br /> Title of Facility operator/Owner <br /> —�� Signature (in ink) <br /> 3L-� log <br /> Date <br /> SlC 12/00 <br />