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COMPLIANCE INFO 2018 - PRESENT
EnvironmentalHealth
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88 (STATE ROUTE 88)
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1900 - Hazardous Materials Program
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PR0520237
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COMPLIANCE INFO 2018 - PRESENT
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Entry Properties
Last modified
11/20/2024 9:23:10 AM
Creation date
6/9/2018 2:17:42 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO 2018 - PRESENT
RECORD_ID
PR0520237
PE
1921
FACILITY_ID
FA0010325
FACILITY_NAME
DESIGNS BY ELEMENTS INC
STREET_NUMBER
18251
Direction
(none)
STREET_NAME
STATE ROUTE 88
STREET_TYPE
(none)
City
LOCKEFORD
Zip
95237
APN
05131034
CURRENT_STATUS
Active, billable
SITE_LOCATION
18251 HWY 88
P_LOCATION
99
P_DISTRICT
004
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\E\HWY 88\18251\PR0520237\COMPLIANCE INFO 2018 - PRESENT .PDF
QuestysFileName
COMPLIANCE INFO 2018 - PRESENT
QuestysRecordDate
4/19/2018 9:34:28 PM
QuestysRecordID
3859666
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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SAN )O A O U I N Environmental Health Department <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the attached Inspection Report must be corrected within 30 days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD)address <br /> at the top of this form within 30 days of receipt of the Inspection Report. HSC 25404.1.2(c)(1) <br /> All corrections to other violations noted in the attached Inspection Report(IR)or Continuation Form, or disputes to any <br /> violations, are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br /> Inspection Report. HSC 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include: <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspection Date: April 11, 2018 Inspected By: JAMIE LIMA <br /> Facility Address: 18251 HWY 88 , LOCKEFORD CERS ID: 10183445 <br /> 1 certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> and I believe the information to be true,accurate, and complete: <br /> Photos Paperwork Statement <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the possibility of a fine <br /> and/or imprisonment for known violations. (HSC 25191) <br /> Name: Title: <br /> Signature: Date: <br /> 1868 E. Hazelton Avenue I Stockton, California 952051 T 209468-3420 1 F 209 464-0138 1 www.sicehd.com <br />
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