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SAN JOAQLO COUNTY OFFICE OF EMERACY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM <br /> RECEIVED <br /> JAN 16 2001 <br /> SAN JOAQUIN CUUIitY <br /> OMCE OF EMERGENCY SERVICES <br /> DECLARATION OF COMPLETENESS AND ACCURACY <br /> I certify under penalty of law that I have personally reviewed the Hazardous Materials Management Plan <br /> and Inventory submitted by my business and have ensured, to the best of my knowledge, it meets the <br /> requirements of the California Health and Safety Code, Chapter 6.95, Article 1. I understand that <br /> false/inaccurate information may contribute to avoidable complications during a hazardous materials <br /> incident. <br /> P <br /> �5 BROADBASE INC. dba JIFFY LUBE #598 <br /> Name of Business <br /> DONALD W. FOWLER <br /> Name of Facility Operator/Owner <br /> OWN <br /> Title of Fa * ity rator/Owner <br /> Signat a (in ink) <br /> 12-11 d /Ze d 6 <br /> Date <br /> SJC 12/00 <br />