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-e''c�� COUNTY OF SAN JOAQUIN <br /> r. :Z OFFICE OF EMERGENCY SERVICES RONALD E. SALOWIN <br /> b. ;( <br /> - I^j ROOM 6/O.COURTHOUSE COORDINATOR <br /> i a 222 EAST WEBER AVENUE <br /> • c•.• `R, j STOCKTON. CALIFORNIA 95202 <br /> 4(I F O R! TELEPHONE(209)4683962 <br /> HAZARDOUS MATERIALS DIVt310N(209)4683969 <br /> [Ply <br /> SAN JOAQUIN COUNTY <br /> 1994 <br /> HAZARDOUS MATERIALS INVENTORY CERTIFICATION FORM <br /> ® I certify that the Iast inventory of hazardous materials submitted to the Office of Emergency <br /> Services in accordance with Section 25505 (d) of Chapter 6.95 of the California Health and <br /> Safety Code has not changed significantly. I understand that a change of more than 100 <br /> percent in the quantity of a hazardous material handled at any one time by a business <br /> constitutes a significant change and must be reported on a Chemical Inventory Form. I <br /> understand that addition of a new hazardous material meeting the reporting requirements of <br /> this program or deletion of a previously reported hazardous material also constitutes a <br /> significant change. <br /> ❑ I certify that all necessary Chemical Inventory Forms for our inventory additions, deletions, <br /> and significant changes from our previously submitted inventory are attached to this Inven- <br /> tory Certification Form. <br /> I declare under the penalty of perjury that the above information is accurate to the best of my <br /> knowledge. I understand that false/inaccurate information may contribute to complications <br /> during a hazardous material incident and that I may be held liable for those actions. This <br /> declaration is made in the City of STOCKTON , California. <br /> Business Name: O.M. SCOTT & SONS <br /> Telephone Number: (209) 887-3845 <br /> Site Address: 23390 E. Flood Rd. Linden, CA 95236 <br /> Mailing Address: PO Box 479 Linden, CA 95236 <br /> Print Name: Jerry Woolsey <br /> Job Title: Plant Manager <br /> Signature: 0 <br /> Date: � - <br />