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6 4 <br /> PQ,,y COUNTY OF SAN JOAQUIN OFFICE OF EMERGENCY SERVICES RONALD R.RALDwIN <br /> ROOM 610,COURTHOUSE DIRECTOR gEO�r,�� <br /> 222 EAST WEBER AVENUE TD <br /> STOCKTON,CALIFORNIA 95202 <br /> ,�ICOp� <br /> TELEPHONE(209)468-3962 DEC 27 2001 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> SANA1Alatllh►C011N�N�f <br /> 2002 HAZARDOUS MATERIALS MANAGEMENT PLA <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page HMMP Unstaffed Facility Network Attachment. and Facility <br /> Map- Check one box only <br /> A. 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. ❑ 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/BAUVIP (HMMP97.FP3 File) and,if <br /> appropriate, our Unstaffed Attachments (STAFF97.FP3 File)has/have been <br /> transmitted concurrently with this Certification Statement. <br /> 2. Chemical Inventory (Chemical Description Pagel - Check one box only <br /> A. ❑ 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 /> B. 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 Contact E-Mail Address (if available) L — r'�' e1� UA0 <br /> I understand that false/inaccurate information may make my company liable in an emergency. I <br /> further certify that I 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. <br /> Business Name <br /> h Y:a x Zi ,Ac' OES Account#Site Address 1 1 3 <br /> 2 VG 1 P 1(I C T(2 r h C1 <br /> Facility Operator/Owner _Td�V^ l L 1t (�1 Title <br /> (ex�Rn <br /> Signature <br /> e.� � Date <br />