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0 <br /> FEB -8 2010 <br /> SANJOAQUIN <br /> AnnnualdRel <br /> Darden <br /> (cation Regsuilemcent nc c OFEMERc�vcrs Ryc <br /> HAZARDOUS MATERIALS INVENTORY <br /> CERTIFICATION STATEMENT <br /> I, the business owner, operator, or officially designated representative, attest to <br /> all of the following according to California Code of Regulations Title 19, Section <br /> 2729.5: <br /> 1. The information submitted on my last annual inventory form dated <br /> 03/02/09 _ (date of last inventory submission) or last annual certification <br /> statement dated N/A to the San Joaquin County Environmental Health <br /> Department is complete, accurate and up to date. <br /> 2. There has been no change in the quantity of any hazardous material that <br /> was reported in the most recently submitted annual inventory form. <br /> 3. No hazardous materials subject to the inventory requirements of California <br /> Health & Safety Code Chapter 6.95 are being handled that are not listed on <br /> the most recently submitted annual inventory form. <br /> 4. The most recently submitted annual inventory form contains the information <br /> required by Section 11022 of Title 42 of the United States Code. <br /> 'Submission of this certification does not meet the annual inventory submission <br /> requirements of the Federal Community Right to Know Law (USC 42, Section <br /> 11022). If your facility is regulated under Federal law, then an annual inventory <br /> submission is required. <br /> I certify that there are no changes to my Hazardous Materials Business <br /> Plan, (except for contact information — see attached Business <br /> Owner/Operator Identification) including phone numbers, addresses, <br /> emergency response plan, employee training plan, site map or chemical <br /> inventory. <br /> Certification: I certify under penalty of law that I have read, understand, and <br /> certify to be true the information contained in this document. <br /> Facility Name: GMRI, Inc. DBA Olive Garden # 1779 <br /> Facility Physical Address: 2671 W. March Lane., Stockton, CA. 95207 <br /> Facility Daytime phone number: 209 954-9018 <br /> Name & Title: Thomas Cipollone — Director Risk Management <br /> Signature & Date: (//, '&� 1/25/10 <br />