Laserfiche WebLink
Q Ti"K <br /> SAN JOAQUIIAOUNTY OFFICE OF EMERGCY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM <br /> OCT -2 2002 <br /> btu10Uhuu1M c'wiiY <br /> DECLARATION OF COMPLETENESS AND ACCURACY?flGEnEEMERGE"G'/bc1iVICE <br /> I certify under penalty of law that I have personally reviewed the Hazardous Materials Management <br /> Plan and Inventory submitted by my business and have ensured, to the best of my knowledge, it <br /> meets the requirements of the California Health and Safety Code, Chapter 6.95, Article 1. 1 <br /> understand that false/inaccurate information may contribute to avoidable complications during a <br /> hazardous materials incident. <br /> TA <br /> 11 Name of Business <br /> Name of Facility Operator/Owner <br /> mt)0 ZA - <br /> Title of Facility Operator/Owner <br /> i6L, <br /> Signature <br /> (Electronic Signature Acceptable if Legible) <br /> 10 ` t 0Z <br /> Date <br />