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SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM "ECEOVE® <br /> JAN 192001 <br /> OFflCE GF EMERGENdY SERnEs <br /> DECLARATION OF COMPLETENESS AND ACCURACY <br /> I certify under penalty of law that I have personally reviewed the Hazardous Materials Management Plan <br /> and Inventory submitted by my business and have ensured, to the best of my knowledge, it meets the <br /> requirements of the California Health and Safety Code, Chapter 6.95, Article 1. 1 understand that <br /> false/inaccurate information may contribute to avoidable complications during a hazardous materials <br /> incident. <br /> AL rNomas nzuca4log lnc <br /> Name of Business <br /> Ao�Ex--r W. Tikot12& <br /> Name of Facility Operator/Owner <br /> t/, Pac-S )zP T <br /> Title of Facility Operator/Owner <br /> Signature (in ink) <br /> �xrn. to }aooi <br /> Date <br /> p� SIC 12/00 <br />