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COUNTY OF SAN JOAQUIN JAN 13 2003 <br /> OFFICE OF EMERGENCY SERVICES <br /> ROOM 610,COURTHOUSE mac, 1 ° "�trrn•• <br /> 222 EAST WEBER AVENUE IFHCEGrtPAERGENit'SfRVICE; <br /> STOCKTON,CA 95202 <br /> f. w .�.. ' TELEPHONE(209)468-3962 <br /> I,r p +�' HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> 2003 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page, Hazardous Materials Management Plan Facility <br /> Map(s) Certification - Check one box only <br /> ❑ 1 certify that there have been no changes to the above listed documents <br /> since our business's last update or change was submitted. <br /> certify that there has been a change to one or more of the above <br /> documents and that appropriate revised hard copy forms have been <br /> submitted with this Certification Statement. <br /> 2. Certification of Chemical Inventory- Check one box only <br /> I certify that the information contained in the most recently submitted <br /> chemical inventory is complete, accurate,up-to-date, and contains the <br /> information required by Section 11022 of Title 42 of the United States <br /> Code. I further certify that there has been no change in the quantity of any <br /> hazardous material reported and that no hazardous materials are being <br /> handled that are not listed. <br /> ❑ I certify that there has been a change in my chemical inventory since the <br /> last submission and completed hard copies of changed Chemical <br /> Description Pages with "Add", "Delete", or "Revised" marked <br /> appropriately have been submitted with this Certification Statement. <br /> I understand that false or inaccurate information may make my company liable in an <br /> emergency. I further certify that I have reviewed the above listed documents and that <br /> the statements checked above constitute an accurate statement. <br /> Business NameLwor_w C,iviF.az3_ JArFp_j_c,, OES Account# <br /> Site Address 2007 /f/ 0 Zz QQ. STOc.KToNC4 9 �� <br /> Operator/Owner L• U Title 1012.CDP MArlyr I fps. <br /> Signature <br />