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v <br /> COUNTY OF SAN JOAQUIN <br /> OFFICE OF EMERGENCY SERVICES COURTHOUSE <br /> 222 EAST WEBER AVENUE, ROOM 610 <br /> STOCKTON, CA 95202 <br /> �S TELEPHONE(209)468-3962 <br /> . HAZARDOUS MATERIALS DIVISION (209)468-3969 <br /> FACSIMILE TRANSMITTAL COVER SHEET <br /> DATE: A/30/07 <br /> NUMBER OF PAGES, INCLUDING COVER SHEET: 3 <br /> SEND TO: Laurie Archer <br /> Business Name: D.A. Archer Excavating_ ID#: 13269 <br /> Facsimile Phone Number: 12091_931. 2874_ <br /> Telephone Verification Number: _(209 601-3745 <br /> IF YOU DO NOT RECEIVE ALL PAGES OR THIS DOCUMENT WAS SENT TO YOU IN ERROR, <br /> PLEASE CALL BACK IMMEDIATELY. <br /> FROM: Robert Lopez_ <br /> Facsimile Phone Number: (2091 A68-0273 <br /> Telephone Verification Number: 12091 A68-3969 <br /> ` Note: Check boxes: Click twice next to box, select "default value", then "OK" <br /> COMMENTS/NOTES: The following are the forms you have requested: <br /> ❑ 2007 Annual Mailing Letter with User Name & Password Information <br /> ❑ 2007 Annual Certification Form with Instructions <br /> ❑ Hazardous Materials Disclosure Survey Form <br /> ❑ CO2 Disclosure Survey Form <br /> ❑ Declaration of Completeness and Accuracy <br /> ❑ Business Owner / Operator Identification Page <br /> ❑ HMMP Page (Emergency Assignment & Spill Control Section) <br /> ❑ Chemical Inventory Page <br /> ❑ Blank Primary Facility Site Ma <br /> ❑ Blank Sub-Ma <br /> ❑ Sample Site Map & Instructions <br /> ❑ <br /> Training Records <br /> ❑ RMP Documents: <br /> ® Other: Notice Of Failure To Comply <br /> 4/30/07 OES Server/Forms/HMMP Program <br />