AFFIDAVIT
REPUBLIC OF THE PHILIPPINES ) s.s.
_________________________________)
I,
ENGR. RICKY S. PARAGAS
of legal age,
single/married, residing at TAMBAC DISTRICT DAGUPAN CITY
after
being sworn in accordance with law, depose and say that:
1. I am an applicant for Hazardous Waste Generator Registration
pursuant to DENR Administrative Order No. 22, Series of 2013
of
RA 6969;
2. I am the PCO/Managing Head of REGION 1 MEDICAL CENTER –
ANNEX located at BONUAN BINLOC DAGUPAN CITY and has been
granted the authority to apply for such document;
3. I attest to the truth, accuracy and genuineness of all the information,
documents and records contained and attached to this application
and that I and ENGR. CRISTITA J. IBASAN, MPA shall be liable for
any misrepresentation, fraudulent declaration and all its
consequences;
4. I am executing this affidavit as a proof of good faith in complying with
the requirements for securing the abovementioned registration.
IN WITNESS WHEREOF, I have hereunto set my hand this _______day
of ___________________ 20__ in ______________________.
ENGR. RICKY S. PARAGAS
Signature over printed name
of affiant