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COMPLIANCE INFO_PRE 2019
EnvironmentalHealth
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1900 - Hazardous Materials Program
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PR0519625
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
2/13/2019 1:58:12 PM
Creation date
6/9/2018 9:15:17 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0519625
PE
1920
FACILITY_ID
FA0005678
FACILITY_NAME
LATHROP SHELL
STREET_NUMBER
16500
Direction
S
STREET_NAME
HARLAN
STREET_TYPE
RD
City
LATHROP
Zip
95330
CURRENT_STATUS
01
SITE_LOCATION
16500 S HARLAN RD
P_LOCATION
07
P_DISTRICT
003
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\H\HARLAN\16500\PR0519625\COMPLIANCE INFO.PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
7/24/2017 11:02:19 PM
QuestysRecordID
3527672
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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• • <br /> Mar 11 09 01: 17p San Joaquin C 203SS36268 p.2 <br /> RECEIVED <br /> . oµ:H COUNTY OF SAN JOAQUIN MAR 112009 <br /> -+ter OFFICE OF EMERGENCY SERVICES <br /> 2t01E.FARHAFtTAVENUE,SUITE)0(t SAN JOAQUINCOUNY <br /> `t STOCKTON,CA 95206 OFFICE CY TOF EMERGEN <br /> �.. TELEPHONE(209)9534200 SERVICES <br /> FAX(709)953-6263 <br /> 2009 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> L. Business Identification Pape Hazardous Minerials Management Plan Facile <br /> Maotsl Certification-Check one box only <br /> 1 certify that there have been no changes to the above listed documents <br /> since our business' last update or change was submitted. <br /> ❑ I certify that there has been a change to one or more of the above <br /> documents and that appropriate revised hard copy farms have been <br /> submitted with this Certification Statement. <br /> 2. Certification of Chemical Inventor'-Check one box only <br /> 1 certify that the information contained in the most recently submitted <br /> chemical inventory is complete, accurate,up-to-date,and contains the <br /> information required by Section 11022 of Title 42 of the United States <br /> Code. I further certify that there has been no change in the quantity of any <br /> hazardous material reported and that no hazardous materials are being <br /> handled in regulated quantities that are not listed. <br /> ❑ I certify that there has been a change in my chemical inventory since the <br /> last submission and completed hard copies of changed Chemical <br /> Description Pages with"Add","Delete",or"Revised"marked <br /> appropriately have been submitted with this Certification Statement. <br /> I understand that false or inaccurate information may make my company liable in an <br /> emergency. I further certify that f have reviewed the above listed documents and that <br /> the statements checked above constitute an <br /> t1 accurate statement. <br /> Business Name Lc, 1 1, a rj S 1, e X Q OES Account 4 <br /> Site Address 0 S 14 1a— 12 0 L c �t„a 2,_CA y � 3 0 <br /> Operator/Owner �c � !�a�7/�^ Title O r n. <br /> Signature ^/fir» Date qtr <br /> l d 4096utwz NVISVO V NOIN <br />
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