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\.W, I.W <br /> SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SE ES _ <br /> HAZARDOUS MATERIALS PROGRAM <br /> C <br /> JAN - 9 2004 <br /> c"w di'.w"'N C1,11"ITY <br /> TICEC;•--- 4ER6ENs'.-31 <br /> i;nCE <br /> DECLARATION OF COMPLETENESS AND ACCURACY <br /> I certify under penalty of law that I have personally reviewed the Hazardous Material <br /> Management Plan and Inventory submitted by my business and have ensured its <br /> completeness and accuracy to the best of my knowledge. I understand that <br /> false/inaccurate information may contribute to avoidable complications during a <br /> hazardous material incident. <br /> JACK IN THE BOX#0534 <br /> Name of Business <br /> JACK IN THE BOX INC. <br /> Name of Facility Operator/Owner <br /> Paul Deneka, Manager Environmental Engineering_ <br /> Title of Facility Operator/Owner <br /> �0_ <br /> Signature (in ink) <br /> /ay <br /> Date <br />