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SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM <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 /> &eteb ee,' (7ri <br /> Name of Business <br /> l <br /> K,�o x s A s s o < (CL- 5 <br /> Name of Facility Operator/Owner <br /> y-A-V\( h l S C e - CAris /� /✓n�( <br /> Title of Facili O erator/Owner <br /> Signature (in ink) <br /> / - 7- & - 0 ( <br /> Date <br /> SJC 12/00 <br />