Laserfiche WebLink
,toe 14� <br /> COUNTY OF SAN JOAQUIN RECEIVED <br /> i. off. OFFICE OF EMERGENCY SERVICES <br /> ROOM 610,COURTHOUSE DEC —5 2003 <br /> j 222 EAST WEBER AVENUE ,��yy� <br /> ./ STOCKTON,CA 95202 FFajEIYB�l1&S R ACE <br /> TELEPHONE(209)468-3962 <br /> HAZARDOUS MATERIALS DIVISION(209)466-3969 <br /> 2004 HAZARDOUS MATERIALS MANAGEMENT PLAN AND INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1. Business Identification Page Hazardous Materials Management Plan, Fac iliri <br /> Man(s) Certification - Check one box only <br /> I 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 bard copy forms have been <br /> submitted with this Certification Statement. <br /> 2. Certification of Chemical Inventory- Check one box only <br /> I 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 /> ❑ 1 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 accurateat)�nn <br /> Business Name OES Alccount <br /> Site Address v <br /> Operator/Owne h Title er- <br /> reSig toate `�� <br />