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SAN JOAOUIN Environmental Health Department <br />Greocness grows here. gl Y <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 RECEIVtD <br />billed at the current hourly rate. AUG U 9 2018 <br />For this certification to be complete, the operator of the site must include: ENWR NT <br />AL A statement documenting what corrective actions were taken or will be taken for each violation PERMIT/SE ES <br />Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos verifying S <br />corrections <br />Operator's certification <br />Inspection Date <br />Facility Address: <br />July 25, 2018 Inspected By: <br />941 MOFFAT BLVD, MANTECA <br />I certify under penalty of law that: <br />NICHOLAS LOEHRER <br />CERS ID: 10184595 <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 e UV�i <br />3. 1 am authorized to submit this certification on behalf of the Respondent. —IN—) 0, <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) J 'Jo <br />e <br />Name: 3 t l a /� Title: !� <br />S i g n a t u rc--,x-a'✓ Date: <br />1868 E. Hazelton Avenue I Stockton, California 952051 T 209 468-3420 1 F 209 464-0138 1 www.sjcehd.com <br />