Laserfiche WebLink
JAN 18 2uuZ <br /> aR!!!M COUNTY OF SAN JOAQUIN !'s„:.�c;,�; :._: ,Iy <br /> OFFICE OF EMERGENCY SERVICES a <br /> @ItGiaflCY SERVICES <br /> < ROOM 610,COURTHOUSE DIRECTOR OF <br /> 222 EAST WEBER AVENUE EMERGENCY OPERATIONS <br /> c.,, Cr• STOCKTON,CALIFORNIA 95202 <br /> �cf c6tiiN TELEPHONE(209)468-3962 <br /> HAZARDOUS MATERIALS DIVISION(209)468-3969 <br /> 2002 HAZARDOUS MATERIALS MANAGEMENT PLAN/INVENTORY <br /> CERTIFICATION STATEMENT <br /> (See Reverse Side for Instructions) <br /> 1 . Business Identification Page HMMP Unstaffed Facility Network Attachment and Facility <br /> Map - Check one box on] <br /> A. ❑ I certify that there have been no changes to the above listed documents since <br /> our business's last update or change was submitted. <br /> B. U I certify that there has been a change to one or more of the above documents <br /> and that either 1) appropriate revised hard copy forms, or 2) a complete revised <br /> electronic copy of our Business ID Page/H UVIP (HMMP97.FP3 File) and, if <br /> appropriate, our Unstaffed Attachments (STAFF97.FP3 File) has/have been <br /> transmitted concurrently with this Certification Statement. <br /> 2. Chemical Inventory (Chemical Description Page) - Check one box only <br /> A. W'� I certify that the information contained in the most recently submitted chemical <br /> inventory is complete, accurate, up-to-date, and contains the information <br /> required by Section 11022 of Title 42 of the United States Code. I 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 are not listed. <br /> B. ❑ I certify that there has been a change in our chemical inventory since the last <br /> chemical inventory was submitted and either 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 (CHEM97 File)has been transmitted with this Statement. <br /> 3. Environmental Contact E-Mail Address (if available) R'c k u bl e m A lAc%t'O C4,2 Corr( <br /> I understand that false/inaccurate information may make my company liable in an 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, Articl.l. �n <br /> Business Name Alo/L za ✓ /n �� .l a <! / / Q"^�t OES Account# 6/44 <br /> Site Address 3938 CA ?5ZO(� <br /> Facility Operator/Owner /� K . /� M A Iia /o Title �c a <br /> /(/PRINT) <br /> Signature /! yyrc//c t/ Date (V_ 16 — 0 Z <br />