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04/19/2002 10:07 2093675401 KNUX AND A55UC1AILb t'AUG eat <br /> _ ._..__ Rpr 18 02 08: 59a E Joaquin DES 209- a-26111) CEIp ED <br /> MewRE V <br /> APR 1 9 <br /> COUNTY OF SAN JOAQUIN fdFftJf:;-, - <br /> >pti'•n� OFFICE OFEMLRGENCYSERVICES NaVALDI.uAtn\\xv <br /> ROOM 610.couitTHOUSE DMEMA Or <br /> 222 EAST WEBER AVPNVE CIERCLI.Cv onca.mcas <br /> '• SJOCXTO N.CAI.IPORN IA 95202 <br /> i` <br /> ILLurHONe(201))469•396: <br /> n^rAAOOUS MATCRIALS CI V ISION 009)4681)969 <br /> 2002 HAZARDOUS ATE I ALS M SAGEM N TPLANANVENTORY <br /> (See Reverse Side for Instructions) <br /> I. $t45inEss Iden[ific noon Px e MP Unslafftd racility Network Att'echment and Fanlity <br /> M n - Check one bpx only <br /> A, ?a I certify that there have been nu cirauges to the above listed doeurnents since <br /> our business's last update or change was submitted. <br /> $, O 1 cernt'y that there has been achanae to one ur nsorc of the,above documents <br /> and that either 1)appropriaoz revised hard copy forms,or 2) a complete revised <br /> electronic copy of our Business ID page/lEvTJ\4P (1-lN1MP97.FP3 File)and,if <br /> approptiare,Our Unstaffed Attachments(STAFFS 7.FP31'ile)has/have been <br /> transmitted concurrently with this Certification Statement. <br /> 2- Chemic I Inventory (Che ical Uesenptiorl Paoe) - Check one box otilv <br /> A. I f I certify that the information contained in the most recently submitted chemical <br /> inventory is complete, accurate, up-to-date,and contains the iuforutation <br /> required by Section 11022 of Title 42 of the United States Code. 1 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 atc not linted- <br /> 13. ❑ I certify that there ha- bee 1I a change in our chemical inventory since the last <br /> chemical inventory was submitted and tether 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 (CI-1EM97 File)has been transmitted with this Statement. <br /> 3. 1 nviro mu iuI Contact.'-Mail Address v'+ilablel <br /> I understand that false/inaccurate information may make my company liable in as 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 Health and Safety Code, Chapter 6.95, Article 1. Q <br /> Busintss Named OES Account :jt? <br /> 2 <br /> 2 (oS� prclr- �.t�TKi✓- _�'A �T S v 7 <br /> Sitc Address r ;J <br /> �j fR / r/L <br /> Facility Operator/Owner <br /> [� i1/OX L SSe• e Ia�S Tltic /rec -fer �' ( 7/e'S <br /> Signals <br /> Date 0 <br />