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des ._ —rs�-- _,r <br /> = a - SECTION 1 <br /> NOTIFICATION <br /> BUSINESS NAME Broadbase Inc. dba JIFFY RUBE <br /> FACILITY STREET ADDRESS 1209 E Hammer Lane <br /> CITY Stockton ZIp 95210 <br /> FACILITYTELEPHONE( 209 ) 957-8730 <br /> MAILING ADDRESS 4000 W Yosemite Road, #7 <br /> CITY Lathrop ZIP 95330 <br /> TELEPHONE ( 209 ) 258 51 A4 <br /> (If diffe=nt fmm Compmy Hndq,,,,) <br /> LOCAL PRIMARY BUSINESS EMERGENCY CONTACT <br /> NAME Paul E. Harbott <br /> RESIDENCE 1184 Wood Duck Court , Man �a o 7 <br /> TELEPHONE(OFFICE)( 209 ) 858-5143 (HOmE)(209 ) 826-6326 <br /> LOCAL ALTERNATE BUSINESS EMERGENCY CONTACT <br /> NAME cr,; ii nngfer <br /> RESIDENCE <br /> TELEPHONE(OFFICE)( 209 )_473-2368 (HOME) (2094 Q49-ABI, pa <br /> 957-8730 �- <br /> 24-HOUR ONSITE CONTACT TELEPHONE ( ) <br /> M Avaaahle) <br /> I declare under the penalty of perjury that I have reviewed this entire Hazardous Materials Manage- <br /> ment Plan and it is accurate to the best of my knowledge- I understand that false/inaccurate infor- <br /> mation may contribute to complications during a hazardous material incident. This declaration is <br /> made in the City of Lathrop California <br /> NAME OFFACIIITYMANAGER/OWNERPaul E. Harbott _TITLE General Manager <br /> WRrm <br /> SIGNATURE: <br /> DATE 11-30-95 <br /> NAMBOFPERSON_ Stephanie Jack TITLE cuctamer service <br /> Responsible for/I the completion of BAIW WRM17 <br /> SIGNATURE � C� l�• ?�Q l(S <br /> DATE <br /> 1995 <br />