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11/17/2006 11:12 2094650'7"9 TOYS R US DC 58 PAGE 08/08 <br />SAN JOAQUIN COUNTY <br />ENVIRONMENTAL HEALTFI DEPARTMENT <br />304 East Weber Avenue, 3rd FIoor, Stockton, CA 95202-2708 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sjgov.org/e4d <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in the "Notice to Comply" in the attached inspection report must be <br />corrected within 30 days of receipt of this inspection. This certification form must be submitted to the <br />Environmental Health Department (EHD) address at the top of this form within 35 days of receipt of the <br />inspection report. <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, or <br />disputes to any violations, are to be submitted using this certification and returned to EHD within 60 days <br />unless otherwise specified in the IR. �' <br />For this certification t0 be COl' plete 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 <br />verifying corrections <br />• Operator's certification <br />Inspection Date:_ 3-06v <br />Inspected By: 44 X _1e4 Al �rl- <br />Facility Address: 16 2 V Aloft ur EPA, ID#: CA /L D o 60 18,50'? <br />F ,5g% <br />S rC<,1eM y 64 S <br />I certify under penalty of law that: <br />I have corrected the violations specified in the Inspection Report from the above-mentioned <br />inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br />EACH VIOLATION and I believe the information to be true, accurate, and complete: <br />Photos V"" Paperwork Statement <br />3. I am authorized to submit this certification on behalf of the Respondent. <br />4. I am aware that there are significant penalties for submitting false information, including the <br />possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br />Name: CTL -s ,e�.eJ /J7/� ,9�/> y Title: . ir%C-1417411;j <br />Si mature: <br />EHID 22-02-005 Rev 12-04 <br />Date: /% /�- U (f <br />:c <br />