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COUNTY OF SAN JOAQUIN <br /> ` + OFFICE OF EMERGENCY SERVICES <br /> X., ROOM 610,COURTHOUSE RECEIVED <br /> 222 EAST WEBER AVENUE <br /> STOCKTON,CA 95202 <br /> TELEPHONE(209)468-3962 JAN 15 2003 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 WWWAAWNNG000N�IpY,nnC <br /> ] 0F#Aogo •Sl.R= <br /> 2003 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page. Hazardous Materials Management Plan Facility <br /> Map(s) Certification - Check one box only <br /> XI certify that there have been no changes to the above listed documents <br /> since our business's last update or change was submitted. <br /> ❑ I certify that there has been a change to one or more of the above <br /> documents and that appropriate revised hard copy forms have been <br /> submitted with this Certification Statement. <br /> 2. Certification of Chemical Inventory - Check one box only <br /> xI certify that the information contained in the most recently submitted <br /> chemical inventory is complete, accurate, up-to-date, and contains the <br /> information required by Section 11022 of Title 42 of the United States <br /> Code. I further certify that there has been no change in the quantity of any <br /> hazardous material reported and that no hazardous materials are being <br /> handled that are not listed. <br /> ❑ I certify that there has been a change in my chemical inventory since the <br /> last submission and completed hard copies of changed Chemical <br /> Description Pages with "Add", "Delete", or"Revised" marked <br /> appropriately have been submitted with this Certification Statement. <br /> I understand that false or inaccurate information may make my company liable in an <br /> emergency. I further certify that I have reviewed the above listed documents and that <br /> the statements checked above constitute an accurate statement. <br /> Business Name TSCT 9R_St>urC" OES Account# 10 4 0 Z— <br /> Site Address Z.o2S Wo) f ✓a-ZeAfov'� Ave— <br /> Operator/Owner TkDA3-, Title &0irD"Ke`4a1 f 12vt�cler <br /> Signature �t i�u�s �'' S c r �Q� Date ( ' 1 3 01 <br />