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PgU1N �o. .cA 2:. i COUNTY OF SAN JOAQUIN a' A OFFICE OF EMERGENCY SERVICES RONALD E. BALDWIN b: RooN 610 COUR OUSE coonoly ATOR 222 EAST WEBER AVENUE STOCKTON. CALIFORNIA 95202 S��F O F� TELEVIgNE Q091 4683962 NAIARp US IAAT Rl I DIVISION 12091 4683969 SAN JOAQUIN COUNTY 1994 HAZARDOUS MATERIALS INVENTORY CERTIFICATION FORM ❑ I certify that the last inventory of hazardous materials submitted to the Office of Emergency Services in accordance with Section 25505 (d) of Chapter 6.95 of the California Health and Safety Code has not changed significantly. I understand that a change of more than 100 percent in the quantity of a hazardous material handled at any one time by a business con- stitutes a significant change and must be reported on a Chemical Inventory Form. I under- stand that addition of a new hazardous material meeting the reporting requirements of this program or deletion of a previously reported hazardous material also constitutes a signifi- cant change. CJ 1 certify that all necessary Chemical Inventory Forms for our inventory additions,deletions, and significant changes from our previously submitted inventory are attached to this Inven- tory Certification Form. I declare under the penalty of perjury that the above information is accurate to the best of my knowledge. I understand that false/inaccurate information may contribute to complications during a hazardous material incident and that I may be held liable for those actions. This declaration is made in the City of S"r'OC 'LTO <1 , California. Business Name: UFsLlpyti ':(:S t Gvxx �prP oA en�p Telephone Number: (209) Qnn��c-52511 //�� Site Address: Yl Vj 1-,t�Qy- 5z, - 0Cy-001j 04, 4520 Mailing Address: JAKFz Print Name: M p.FyV<' X. VI KIS,j-f Job Title: C-6NERp ,'�^PINA EY Signature: Date: