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FWOM QUALITY TUNE-UP ri9 PHONE NO. : 209 547 9085 Dec. 22 2015 08:51PM P1 <br /> San Joaquin County REvE:l V EL) <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> Telephone:(209) 468-3420 Fax:(209)468-3433 Web:v�(,Sjgov or,/o ehd DEC 2 3 2015 <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> EHCAITW NVIRONMENTAL <br /> Any MIN _R_violations noted in the"Notice to Comply" in the attached Inspection Report must be corrected within 30 dim of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD)address+ <br /> the top of this form within 30 days of receipt of the Inspection Report. MSC 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 resultslmanifests/training recordslother appropriate paperwork,and/or photos verifying corrections <br /> Inspection Date: November 23, 2015 Inspected By: HAZA SAEED <br /> Facility Address: 7730 HOLMAN RD STOCKTON EPA ID: tpGO ^I O a 4_ <br /> I certify under penalty of law that: <br /> 1. 1 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 /> 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 and/ <br /> imprisonment for known violations. (HSC 25191) <br /> Name: <br /> Ix "013-0 Title: d ' <br /> Signature: Date: Za 1 'f <br />