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RECEIVED APR 14 2005 SAN JOAQUIN COUNTY UFFICF OF c! Frlclllry 9F^`.'r COUNTY OF SAN JOAQUIN RECEIVED OFFICE OF EMERGENCY SERVICES APR 12 2005 ROOM 610,COURTHOUSE 222 EAST WEBER AVENUE SAN JOAQUIN COUNTY STOCKTON,CA 95202 OFFICE OF EMERGENCY SERVICES TELEPHONE(209)468-3962 HAZARDOUS MATERIALS DMSION(209)468-3969 2005 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY CERTIFICATION STATEMENT (See Reverse Side for Instructions) 1. Business Identification Page Hazardous Materials Management Plan.Facility Man(s) Certification- Check one box only I certify that there have been no changes to the above listed documents since our business's last update or change was submitted. ❑ I certify that there has been a change to one or more of the above documents and that appropriate revised hard copy forms have been submitted with this Certification Statement. 2. Certification of Chemical Inventory -Check one box only I certify that the information contained in the most recently submitted chemical inventory is complete, accurate,up-to-date,and contains the information required by Section 11022 of Title 42 of the United States Code. I further certify that there has been no change in the quantity of any hazardous material reported and that no hazardous materials are being handled that are not listed: ❑ I certify that there has been a change in my chemical inventory since the last submission and completed hard copies of changed Chemical Description Pages with"Add","Delete",or"Revised" marked appropriately have been submitted with this Certification Statement. I understand that false or inaccurate information may make my company liable in an emergency. I further certify that I have reviewed the above listed documents and that the statements checked above constitute an accurate statement. Business Name�C�-`_— O��^ OES Account# 6 Site Address `mac- Operator/Owner G Title Date Signature I 'd 90S[SZ660Z aauey0 Ito eapaedS eSb :60 SO bi udH