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S <br /> SAN JOAQUN COUNTY <br /> RDOUS OFFICE <br /> OF <br /> PROGRAM SERVICES <br /> I <br /> RECEIVED <br /> JAN 1 0 2001 <br /> 0MCE SANF JCAGUIN CCUMY <br /> EWRGENCY SERVICES <br /> DECLARATION OF COMPLETENESS AND ACCURACY RECEIVED <br /> FEB 7 2001 <br /> 1 certify under penalty of law that I have personally reviewed the Hazardous Materials Management Nall, <br /> and Inventory submitted by my business and have ensured, to the best of my knowledge, it meets the , VICES <br /> requirements of the California Health and Safety Code,Chapter 6.95,Article 1. 1 understand that <br /> false/inaccurate information may contribute to avoidable complications during a hazardous materials <br /> incident. /� ---��-- <br /> �(5P- �d CrLIAZ ,tjl/li0D41 <br /> Name of Business <br /> A %nV <br /> Name of Facility Operator/Owner <br /> Title of Facility Operator/O ger <br /> Signature (in ink) <br /> mO <br /> ate <br /> SJC 12/00 <br />