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S N OJ AQUIN COUNTY UNIFI GR AGENCY <br /> NVIRONMENTAL HEALTH DEPARTMENT <br /> 04 E. WEBER AVENUE <br /> TOCKTON, CA 95202 <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous Waste <br /> Generators <br /> In the matter of the Violation cited on: <br /> As Identified in the Inspection Report dated: <br /> Conducted by: [EHD Inspector(s)] <br /> 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 /> Facility Address EPA ID. Number <br /> /amu 1 . OC4 <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> EHDCERT(rev 1/07102) <br />