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:-C----------------------------------------------------------------------------------------------------------------- <br /> USED OIL ONLY _ <br /> Facility Name: � " � <br /> Facility Street Address: 3! �V, <br /> City: ss77� <br /> Contact Person: Phone:aypp— 31 4// <br /> I certify that the only hazardous waste generated by the above referenced Facility is USED <br /> OIL and that the total amount rated per ari ess than 5 tons. <br /> Signed: . <br /> A Division of San Joaquin County Health Care Services <br /> s <br /> • r <br />