Laserfiche WebLink
SAN JOAQUIN <br />Environmental Health Department <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in the Notice to Comply in the attached Irrsur ' tri Report must be WaWilld wririrn X dais of <br />receipt of this mSpeCtran This Cer[rftaatlon form must tx submitted to the Environmental Health Department (EHD) address <br />at the Sop of this form Within 30 days o1 receipt of the Inspectlon Repoli NSC 26444 t 2(c)(1 t <br />Alt &Oeoions to, 9ther� noted in the attached inspection Report (IR) or Comnuatron (Form or :iispums to any <br />violations are to be submitted using this certification and resumed to EHD within 30 days unless other nse speUfwa in the <br />Inspection Report. HSC 26785(c)f31 <br />Note: All EHD staff time associated with failing to comply by the above noted dates trnll be <br />billed at the current hourly rate. <br />Far this certification to he complete, the operator of the site must include <br />A swemen[ documenting whal currectrve actons were taKen or will be taken for each +nolalion <br />Copes of sample re5ults.•manrfesmiraining reGardsrother appropriate pawworh andior photos verifying <br />corretbons <br />Operators CerVhCatlon <br />Inspection Date: May 17 2018 Inspected 8y: <br />Facility Address: 720 E HAMMER LN STOCKTON <br />I cerbN under penalty of law that <br />JAMIE LIMA <br />CERS ID: 10182965 <br />I have corrected the volationS Specified to the inspection Report from the above-mentioned inspection date <br />1 nave personally examined the following documentation submitted es proof of compliance FOR EACH VIOLATION <br />and I believe tie rn}ormatton to be true accurate and complete <br />Photos Paperwork �tatement <br />3 1 am author•2ed to submit this certitcatron on behalf of the Respondent <br />s f am aware that were are significant penalties for submitting false mlormation including the possibility of a fine <br />and or rmprm <br />.sonenl for known violations (HSC 25191 ) L <br />Name f7Ylll&fLj�(r �C4 Vd »'U_ Tdle::!�V NZIAW1 T <br />RcCEfVED <br />JUN 14 pig <br />EN!rIRDWEIVTAI_ <br />1956 z Hazettor• Avenue i Stockton California BFsu:I T Z-VJ463,A201 F 20P41,4-0138 I `"v4.;Pe4T-M-'nr:la4fa'rN'FNT <br />