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USED OIL ONLY <br /> Facility Nam /� i ar <br /> Facility Street Address: 3 OOH At i�, ( 'P�.r�ee it <br /> City: I <br /> Contact Person: Phone: Z/27 33 7f� <br /> I certify that the only hazardous to gene by the above referenced Facility is USED <br /> OIL and that the total amoun enera r year is less than 5 tons. <br /> Signed <br /> A Division of San Joaquin Counry Health Care Services <br /> ,J <br />