COMPLIANCE INFO_PRE 2019 - Laserfiche WebLink

Home Browse Search

F ^EIO/ED COUNTY OF SAN JOAQUIN h OFFICE OF EMERGENCY SERVICES UEC —!� 2003 F ROOM 610,COURTHOUSE wuuullY 222 EAST WEBER AVENUE F19CE0FEMEFGENCV SERMCE STOCKTON,CA 95202 TELEPHONE(209)468-3962 HAZARDOUS MATERIALS DIVISION(209)468-3969 2004 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY CERTIFICATION STATEMENT (See Reverse Side for Instructions) 1. Business Identification Page, Hazardous Materials Management Plan, Facility Map(s) Certification - Check one box only I certify that there have been no changes to the above listed documents since our business's last update or change was submitted. ❑ I certify that there has been a change to one or more of the above documents and that appropriate revised hard copy forms have been submitted with this Certification Statement. 2. Certification of Chemical Inventory - Check one box only I certify that the information contained in the most recently submitted chemical inventory is complete, accurate, up-to-date, and contains the information required by Section 11022 of Title 42 of the United States Code. I further certify that there has been no change in the quantity of any hazardous material reported and that no hazardous materials are being handled that are not listed. ❑ I certify that there has been a change in my chemical inventory since the last submission and completed hard copies of changed Chemical Description Pages with "Add", "Delete", or"Revised"marked appropriately have been submitted with this Certification Statement. I understand that false or inaccurate information may make my company liable in an emergency. I further certify that I have reviewed the above listed documents and that the statements checked above constitute an accurate statement. / Business Name ( I I S t ( l1 Ate' OES Account# C) + Site Address q,--X, 1' 4C 1 C( L Operator/OwnerJ Q l N 1 1 Title M c o QC�) n 0 Signature Date 3