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... <br />N" <br />COUNTY OF SAN JOAQUIN <br />aQ°64,y eco OFFICE OF EMERGENCY SERVICES RONALD I- BALDWIN <br />ROOM 610, COURTHOUSE <br />` 222 EAST WEBER AVENUE , <br />ED <br />STOCKTON, CALIFORNIA 95202 <br />•���ik6'M1`��r• <br />TELEPHONE (209) 468-3962 JAN 1 1 2002 <br />HAZARDOUS MATERIALS DIVISION (209) 468-3969 80a"tNcOUNTY <br />SERVICE• <br />2002 HAZARDOUS MATERIALS MANAGEMENT PLANRMfli <br />CERTIFICATION STATEMENT <br />(See Reverse Side for Instructions) <br />A. �a/ <br />I certify that there have been no changes to the above listed documents since <br />our business's last update or change was submitted. <br />B. ❑ <br />I certify that there has been a change to one or more of the above documents <br />and that either 1) appropriate revised hard copy forms, or 2) a complete revised <br />electronic copy of our Business ID Page/H fl%4P (HAINIP97.FP3 File) and, if <br />appropriate, our Unstaffed Attachments (STAFF97.FP3 File) has/have been <br />transmitted concurrently with this Certification Statement. <br />2. ChemicalInvents (Chemical Description Page) - Check one box only <br />A. aPkI <br />I certify that the information contained in the most recently submitted chemical <br />inventory is complete, accurate, up-to-date, and contains the information <br />required by Section 11022 of Title 42 of the United States Code. I further <br />certify that there has been no change in the quantity of any hazardous material <br />reported and that no hazardous materials are being handled that are not listed. <br />/ <br />B. C3 <br />I certify that there has been a change in our chemical inventory since the last <br />chemical inventory was submitted and either 1) completed hard copies of <br />Chemical Description Pages with "Add', "Delete", or "Revised" marked <br />appropriately, or 2) a complete revised electronic copy of our chemical <br />inventory (CHEM97 File) has been transmitted with this Statement. <br />3. Environmental <br />Contact E -Mail Address (if available) <br />I understand that false/inaccurate information may make my company liable in an emergencN. 1 <br />further certify that 1 have reviewed the above listed documents and information contained in the <br />most recently submitted chemical inventory and have ensured that it meets the requirements of <br />California Health and Safety Code, Chapter 6.95, Article 1. /f <br />Business Name OES Account # c <br />f <br />Q <br />Site Address ( r �'/�t/� � urt -, A D <br />Facility Operator/Owner �6,n,+IAi 04L Am+ Titlef�St09-I'l- <br />��//7//J �wirn /q jj /1 <br />Signature X02 i:%%/'i L^7(%�uw - - - Date it � 1/ qf�y V� <br />