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.,_. 1.04, <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 600 East Main Street,Stockton,CA 95202-3029 <br /> Telephone:(209)468-3420 Fax.(209)468-3433 Web:wvvw.si¢ov.otg/ehd <br /> RETURIN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations nowd 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 retumed to EHD within 30 days <br /> unless otherwise specified in the Inspection Report. �T <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be billed at <br /> 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 <br /> verifying corrections <br /> • Operator's certification <br /> Inspection Date: May 29, 2009 Inspected By: Ray Von Flu <br /> 1616 Boeing Way <br /> Facility Address:Stockton, CA 95206 EPA ID#: CAL 000 316774 <br /> I certify under penalty of law that: <br /> 1. 1 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 l believe the information to be true, accurate,and complete: <br /> Photos X Paperwork X 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 <br /> possibility of a tine and/or imprisonment for known violations. (HSC 25191 <br /> Name: Tatsuo- Ishida Title: 'CEO / President <br /> T Signature: " zi) Date: June 16, 2009 <br /> EHD 22-02-005 Rev 11/07 <br />