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2-12-2002 4:07PM FROM SAN JOAOUIN CO. OES 209 944 9015 P. 2 <br /> v +,a COUNTY OF SAN JOAQUIN <br /> —' OFFICEOF EMERGENCY SERVICES ROr/N.D E BA1ECEIVED <br /> «' . ROOM 610,COURTHOUSE DIRECTOR OF V <br /> 222 EAST WEBER AVENUE EMEaGENCY OPERA fNa <br /> STOCKTON.CALIFOR'V1A 95202 rr CC 14 2082 <br /> TELEPHONE(20.)468-3962SMIJOAUWNc()U <br /> HAZARDOUS Wy <br /> MATERIALS DIVISION(207)468-3969 0"ICEOFEA"GENCYS REICES <br /> 2002 HAZARDOUS MATERIALS MANAGEMENT PLAN/INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page HMMP Unstaffed Facility Network Attachment and Facility <br /> Map - Check one box only <br /> A. .® I certify that there have been no changes to the above listed documents since <br /> our business's last update or change was submitted. <br /> B. ❑ I certify that there has hem a change to one or more of the above documents <br /> and that either 1)appropriate revised hard copy forms,or 2)a complete revised <br /> electronic copy of our Business ID Page/HNEVIP(HMMP97.FP3 File)and,if <br /> appropriate,our Unstaffed Attachments(STAFF97.FP3 File)has/havc been <br /> transmitted concurrently with this Certification Statement. <br /> 2. Chemical Inventory (Chemical Descrirtion Paae) - Check one b9x9n1v <br /> A. i I 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 Cotte. I farther <br /> certify that there lies been no change in the quantity of any hazardous material <br /> Deported and that no hazardous materials are being handled that are not listed. <br /> B. ❑ I certify that there hasten a change in our chemical inventory since the last <br /> chemical inventory was submitted and el a 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 File)has been transmitted with this Statement. <br /> 3. Environmental Contact E-Mail Address(if available) <br /> 1 understand that false/inaccurate information may make my company liable in an emergency. I <br /> further certify that I have reviewed the above listed documents and information contained In the <br /> most recently submitted chemical inventory and have ensured that it meets the requirements of <br /> California Health and Safety Code, Chapter 6.95, Article 1. <br /> _/V7 7� �r ZZ - _ 82-18 <br /> Business Name !/2J )/O.i�/ / � OES Account N <br /> Site Address 61-0o S �i6U/� 44 '1 �' <br /> Facility Operator/Owner / Title <br /> Signature Date <br />