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pay H c COUNTY OF SAN JOAQUIN <br /> aa�Ea .oma <br /> OFFICE OF EMERGENCY SERVICES <br /> RONALD&BALDWIN <br /> ROOM 610,COURTHOUSE RW , D <br /> 222 EAST WEBER AVENUE � t�J <br /> STOCKTON,CALIFORNIA 95202 DEC 2 7 2001 <br /> TELEPHONE(209)468-3962 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 IM G011N1Y <br /> 2002 HAZARDOUS A TIFI ALS M AGSM N TPLA � ' <br /> (See Reverse Side for Instructions) <br /> 1 . Business Identification Pape 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 been a change io 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/flM1%4P (HMMP97.FP3 File) and, if <br /> appropriate, our Unstaffed Attachments (STAFF97.FP3 File) has/have been <br /> transmitted concurrently with this Certification Statement. <br /> 2. Chemical Inventory (Chemical Description Pape) - Check one box only <br /> A. 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 Code. I further <br /> certify that there has been no change in the quantity of any hazardous material <br /> reported and that no hazardous materials are being handled that are not listed. <br /> B. ❑ I certify that there has been a change in our chemical inventory since the last <br /> chemical inventory was submitted and either 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) Cr, 14 L C CY o 1. col& 1 <br /> I understand that false/inaci ura a norma on may ma a my company ra e m 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 /> I <br /> Business Name (,Cs JJ OES Account #�� <br /> Site Address lZ4 70 LOC-Kc Zor-d � 4 loth <br /> Facility Operator/Owner d ld Titlen �e�r — �U f� <br /> Signature Date 17— <br /> /�7 �0 <br />