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SAN JOAQUIN COUNTY UNIFIED PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DEPARTMENT lo <br /> -'EcE V LSD <br /> 304 E.WEBER AVENUE <br /> STOCKTON,CA 95202 <br /> FNvNgOVV��2 0 2003 <br /> CERTIFICATION OF RETURN TO COMPLTP,�1t&�;:;ENTHEALTH <br /> SERVICES <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: 10 /1:2 03 <br /> As Identified in the Inspection Report dated: -10 /2-310--" <br /> Conducted by: ::5�7V\h [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1 . Respondent has corrected the violations specified in the notice of <br /> violation cited above. <br /> 2. 1 have personally examined any documentation attached to the <br /> certification to establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and <br /> inquiry of the individuals who prepared or obtained it, I believe that <br /> the information is true, accurate, and complete. <br /> 4. 1 am authorized to file this certification on behalf of the Respondent. <br /> 5. 1 am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for <br /> knowing violations. <br /> t� Co.ClTta -(�JL <br /> Facility Address EPA ID. Number <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> EHDCERT(rev 1107102) <br />