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2200 - Hazardous Waste Program
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PR0517954
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COMPLIANCE INFO
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Entry Properties
Last modified
12/5/2018 10:43:28 AM
Creation date
10/31/2018 12:53:01 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2200 - Hazardous Waste Program
File Section
COMPLIANCE INFO
RECORD_ID
PR0517954
PE
2220
FACILITY_ID
FA0010824
FACILITY_NAME
VINTAGE PRODUCTION CA LLC
STREET_NUMBER
12350
Direction
S
STREET_NAME
CROCKER
STREET_TYPE
RD
City
STOCKTON
Zip
95206
APN
191-040-02
CURRENT_STATUS
02
SITE_LOCATION
12350 S CROCKER RD
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\C\CROCKER\12350\PR0517954\COMPLIANCE INFO.PDF
QuestysFileName
COMPLIANCE INFO
QuestysRecordDate
5/13/2014 8:44:28 PM
QuestysRecordID
2438221
QuestysRecordType
12
QuestysStateID
1
Tags
EHD - Public
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I <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMEM• -� <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www.siaov.oralehd <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 30 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 30 days <br /> unless otherwise specified in the Inspection Report. <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be <br /> billed at the current hourly rate of$105 (beginning 8/1/09 the hourly rate will be $115). <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: Inspected By: <br /> I <br /> Facility Address,���� ,iF�j/sr/�EPA ID#: <br /> I certify under penalty of law that: <br /> 1. 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_ _Paperwork -__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 fine <br /> n�cJ/or imprisonment for known violations. (HSC 25191) <br /> b ` %'�E' <br /> Name: _� Title: <br /> Signal Date: <br /> 22-020D5 R-05M <br />
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