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STATE OF CALIFORNIA ` ERNOR'S OFFICE OF EMERGENCY SERVICES <br /> CALIFORNIA ACCIDENTAL REOSE PREVENTION is <br /> PROGRAM REGISTRATI{] , p'�± �p <br /> OES 2735.6(NEW 6/97) 2 7 PAGE 1 OF 1 <br /> REGISTRATION TYPE UPDATE TYPE <br /> Read instructions on reverse efo �uJu 0- UN3Y NEW ❑ UPDATE ADD DELETE ❑ REVISE <br /> I. Business Owner/Operat& Information <br /> BUSINESS NAME <br /> Linden County Water District <br /> ADDRESS (Number and Street) <br /> 18243 E_ Hwy 26 <br /> CITY COUNTY STATE ZIP CODE <br /> Linden , CA 95236 San Joaquin CA 95236 <br /> OWNER/OPERATOR NAME PHONE NUMBER <br /> Teresa Tanaka General Manager ( 209 ) 887-3216 <br /> II. Regulated Substance List <br /> Process Max. <br /> A. Name of Each Regulated Substance Quantity (Ibs) CAS# <br /> 1. Chlorine i50 lbs 1 /782--50 5 <br /> 2. <br /> -T- <br /> 3. <br /> 1 <br /> 4. <br /> 5. <br /> 6. <br /> 7. <br /> 8. <br /> Regulated Substance in a Mixture Percent Process Max. CAS# <br /> B. Name of Each Re <br /> g Weight Quantity(lbs) <br /> 1. <br /> 2. <br /> III. Certification <br /> I, the owner or operator of the aforementioned business, hereby certify that the registration information provided <br /> above is true, accurate, and complete to the best of my knowledge, based upon reasonable inquiry. 1 am fully aware <br /> that this certification, executed on the date indicated below, is made under penalty of perjury under the laws of the <br /> State of California. <br /> OWNER/OPERATOR NAME(PRINT) <br /> Teresa Tanaka <br /> OWNER/OPERATQRfIGNATURE DATE EXECUTED <br /> oz 68-25-9 9 <br />