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3AN JOAQUIN COUNTY UNIF ) PROGRAM AGENCY ,p . <br /> ENVIRONMENTAL HEALTH DEPARTMENT " <br /> 304 E. WEBER AVENUE ,�n p( <br /> STOCKTON, CA 95202 ' <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: g 3 <br /> As Identified in the Inspection Report dated: (�( 0 <br /> Conducted by: SQA -� Vd/, l r("C. [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 /> AM4x , , <br /> 550 CAr-N e5CA L 00000 223 -7 <br /> Facility Address EPA ID. Number <br /> Name (Print or Type) Title �� <br /> Signature v Date Signed <br /> EHDCERT(rev 1107/02) <br />