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HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br />CERTIFICATION STATEMENT <br />Use this form to meet certification requirements if you are not using the HMMP <br />Compliance Web Site to submit your certification. <br />Please review your HMMP and inventory and follow these instructions. <br />If there are no changes to the Business Identification Page, Hazardous Materials <br />Management Plan (HMMP), Unstaffed Facility Network Attachment(s) (if <br />applicable), and Facility Map(s) that you last submitted to the Office of <br />Emergency Services, then place a check in the first box under Statement #1. <br />If there have been aU changes to one of the documents listed in #1 above, <br />then submit a hard copy of the revised document(s) completed in its entirety <br />with the corrected information along with the signed and dated Certification <br />Statement. Blank forms are available at the San Joaquin County Office of <br />Emergency Services, 222 E. Weber Avenue, Room 610, Stockton. <br />Place a check in the second box under Statement #1 prior to signing the form. <br />If there are Ila changes to the chemical inventory, including no change in <br />quantities previously reported, then place a check mark in the first box under <br />Statement #2. <br />4. If there has been a change to the chemical inventory reported for one or more <br />chemicals, please make updates as follows. Submit a completed hard copy of <br />changed or new Chemical Description Page(s) marked "Add" or "Revised." If <br />you have deleted a chemical from your inventory, send a copy of the last chemical <br />description page submitted marked "delete" at the top. Submit these updated <br />documents together with the Certification Statement. <br />-5. Make sure there is a check mark in one of the boxes under both Statement #1 and <br />Statement #2, then sign and date the Certification Statement and submit to our <br />office with the appropriate updated forms by the deadline of January 16, 2003. <br />NOTE: State law requires that you report a 100% change in the quantity of a <br />previously reported material. <br />Be sure to update the copy of your HNIMP and inventory used by your employees <br />with the same changes. If you need assistance, please call our office at (209) 468 3969. <br />