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_____------------------------------- <br /> -------------------------------------------------------------------------- <br /> USED OIL ONLY <br /> � v� / <br /> Facility Name: L 1cs <br /> Facility Street Address: <br /> C ity: �o i OL - 9SOWC <br /> �_ 3 Z <br /> Contact Person: <br /> I certify that the only hazardous waste generated by the than 5 bove referent <br /> ed Facility is USED <br /> OIL and that the total amount gene ate er ye le <br /> Signed G <br /> A Division of San Joaquin County Health Care Services <br />