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SAN JOAQUIN COUNTY OFFICE OF EMERGENCY SERVICES <br /> HAZARDOUS MATERIALS PROGRAM <br /> RECEIVED <br /> DEC 2 9 200 <br /> ;)FFICE OF MERGENCY ERVICES <br /> DECLARATION OF COMPLETENESS AND ACCURACY <br /> I certify under penalty of law that I have personally reviewed the Hazardous Materials Management Plan <br /> and Inventory submitted by my business and have ensured, to the best of my knowledge. it meets the <br /> requirements of the California Health and Safety Code, Chapter 6.95, Article 1. 1 understand that <br /> false/inaccurate information may contribute to avoidable complications during a hazal-JOus materials <br /> incident. <br /> -'-�"'— <br /> ! Name of Business <br /> 1 e <br /> Name of Facility Operator/Owner <br /> C.. • . _ <br /> Title of Facility Operator/Owner <br /> Sig ture (in ink) <br /> 7 <br /> Date <br /> SJR' 12/03 <br />