Laserfiche WebLink
i <br /> i <br /> I <br /> 2315 N. EI Dorado St. <br /> Stockton, CA 95207 <br /> r <br /> NO DISCHARGE OF GROUNDWATER OCCURRED AT THIS LOCATION <br /> DURING(MONTH/YEAR) ZOO <br /> 1 certify under penalty of law that this docur hent and all attachments were prepared under my <br /> direction or supervision in accordance with a system designed to assure that qualified personnel <br /> properly gather and evaluate the information submitted. Based on my inquiry of the person or <br /> persons who manage the system,or those persons directly responsible for gathering the information, <br /> the information submitted is,to the best of my knowledge and belief,true,accurate,and complete. t <br /> ani aware that there are significant penalties for submitting false information, including the <br /> possibility of fine and imprisonment for knowing violations. <br /> C-16X7•E OFFICER <br /> PRINT NAME <br /> TITLE ----- - <br /> f <br /> I <br />