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COMPLIANCE INFO_PRE 2019
Environmental Health - Public
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1900 - Hazardous Materials Program
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PR0519809
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COMPLIANCE INFO_PRE 2019
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Entry Properties
Last modified
2/1/2019 11:18:15 AM
Creation date
6/9/2018 1:37:58 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
PRE 2019
RECORD_ID
PR0519809
PE
1921
FACILITY_ID
FA0002541
FACILITY_NAME
7-ELEVEN INC #20632
STREET_NUMBER
4627
STREET_NAME
DA VINCI
STREET_TYPE
DR
City
STOCKTON
Zip
95207
APN
11002003
CURRENT_STATUS
01
SITE_LOCATION
4627 DA VINCI DR
P_LOCATION
01
P_DISTRICT
002
QC Status
Approved
Scanner
EJimenez
Supplemental fields
FilePath
\MIGRATIONS\D\DA VINCI\4627\PR0519809\COMPLIANCE INFO.PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
11/9/2015 7:04:30 PM
QuestysRecordID
2916955
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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Qu►,� COUNTY OF SAN JOAQUIN / <br /> off_. .... . c <br /> OFFICE OF EMERGENCY SERVICES Lb E.RAL <br /> y ROOM 610,COURTHOUSE `^� CF�FF OF <br /> 222 EAST WEBER AVENUE E,M �"N li"TiONS <br /> STOCKTON,CALIFORNIA 95202 <br /> �rFda TELEPHONE(209)468-3962 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> 2000 HAZARDOUS MATERIALS MANAGEMENT PLAN/INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page, HMMP, Unstaffed Facility Network Attachment and Facility <br /> Ma - 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/HMMP(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 Inv nto Chemical Description Pae - 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.L3DF `� I r � <br /> 3. Environmental Contact E-Mail Address if available): LJ&l I C Cam <br /> r' I <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 tleallt7h and Safety Code, Chapter 6.95, Article 1, <br /> Business Name =2663a` OES Account# 50 7fs- <br /> Site Address-4��2 7 LQ a. kQx• ; ��` �I ca---,_ <br /> Bob DeNinno Environmental Manager f <br /> Facility Operator/ w er Title _ <br /> IPRINTI <br /> Signature Date ��A <br />
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