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COUNTY OF SAN UIN JOA <br /> Q <br /> ' OFFICE OF EMERGENCY SERVICES <br /> ' ROOM 610,COURTHOUSE <br /> 4 1 222 EAST WEBER AVENUE <br /> STOCKTON, CA 95202 <br /> e�tt <br /> TELEPHONE(209)468-3962 <br /> I IAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> FACSIMILE TRANSMITTAL COVER SHEET <br /> DATE: - /s - 7 <br /> NUMBER OF PAGES, INCLUDING COVER SHEET: <br /> SEND TO: Ce-AiG Co4-3tt�I <br /> Business Name: K'FC. i AtLi Coo -*,`r ID#: /32 55- <br /> Facsimile Phone Number: 2. 09 - 55-Z • / 951.E <br /> Telephone Verification Number: Z04 ^ 95-Z - 7/L ' <br /> IF YOU DO NOT RECEIVE ALL PAGES OR THIS DOCUMENT WAS SENT TO YOU IN ERROR, <br /> PLEASE CALL BACK IMMEDIATELY. <br /> FROM: L-.e s.J Et.t-- <br /> Facsimile Phone Number: 12091 468-0273 <br /> Telephone Verification Number: (2091 468-3969 <br /> " Note: Check boxes: Click twice next to box, select "default value", then "OK" <br /> COMMENTS/NOTES: The following are the forms you have requested: <br /> ❑ Hazardous Materials Disclosure Survey Form <br /> ❑ CO2 Disclosure Survey Form <br /> ❑ Declaration of Completeness and Accuracy <br /> ❑ Business Owner / Operator Identification Page <br /> ❑ HMMP Page (Emergency Assignment & Spill Control Section) <br /> ❑ Chemical Inventory Page <br /> ® Blank Primary Facility Site Map Blank Sub-Ma <br /> ❑ Sample Site Map & Instructions <br /> ❑ Training Records Form ❑ Training Records Instructions <br /> ❑ RMP Documents: ❑ Records Request Form <br /> htAP SN T cscT/o•J <br /> ❑ 2007 Certification Form W/ Instructions <br /> ❑ 2007 Annual Mailing Letter W/ User Name & Password Information <br /> 12/8/06 OES Server/Forms/HMMP Program <br />