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ua ZS/ZUUJ 18:25 FAX 3108305149 ACA/ET RESTAURANTS IaJ 007 <br /> i"- COUNTY OF SAN JOAQUIN ` , <br /> f ate" Fa OFFICE OF EMERGENCY SERVICES REOE�`�E® <br /> ROOM 6I0,COURTHOUSE l)lF{ <br /> 222 EAST WEBER AVENUE MAR 2 K 2 <br /> STOCKTON,CA 95202 <br /> TELP,PHONE(209)968-3962 �;y <br /> IIAZARDOUS MATERIALS DIVISION(209)468-3969 ��181C�roc+�• <br /> 2003 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1- Business Identification Page. Hazardous Materials Management Plan,Facility <br /> Maps)Certification- Check one box only <br /> Cx�t I certify that there have been no changes to the above listed documents <br /> _- ------ ❑-tee eurbusiness'slasE-update-orchawe was submitted. <br /> I <br /> — - ----- —__ <br /> certify that there has been a change to one or more of the above <br /> documents and that appropriate revised hard copy forms have been <br /> submitted with this Certification Statement- <br /> s. Certification of Chemical Inventory-Check one box onh• <br /> 1Y I certify that the information contained in the most recently submitted <br /> chemical inventory is complete, accurate, up-to-date, and contains the <br /> information required by Section 11022 of Title 42 of the United States <br /> Code. I further certify that there has been no change in the quantity of any <br /> hazardous material reported and that no hazardous materials are being <br /> handled that are not listed. <br /> ❑ I certify that there has been a change in my chemical inventory since the <br /> last submission and completed hard copies of changed Chemical <br /> Description Pages with"Add","Delete", or"Revised"marked <br /> appropriately have been submitted with this Certification Statement. <br /> — — - I rteratand"ttiaTfaTse oriaaccura�e information mxy make my company liable in an <br /> emergency. I further certify that I have reviewed the above listed documents and that <br /> the statements checked above constitute an accurate statement. <br /> Business Name Et ToTito Mexican Restaurant OES Account# 9401 <br /> Site Address 2593 West March Lane, Stockton, CA 95209 <br /> Operator/Owner George P. Harbison^ Title .CFO - <br /> Signature �� ,�r v Date 03/25/03 <br />