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:NVXRONMENTAL HEALTH 1)E#TMENT �_.,... <br />04 E. WEBER AVENUE <br />T4CKTON, CA 95202 <br />0 <br />CERTIFTrATION OF RETURN TO COMPLIANCE <br />For Hazardous Waste Generators <br />In the matter of the Violation cited on : 6'R tq <br />As Identified in the Inspection Report dated dry) V -Dq <br />Conducted by ItrnD, <br />[EHD Inspector(s)] <br />I certify under penalty of law that: <br />Respondent has corrected the violations specified in the notice of violation <br />cited above. <br />2. I have personally examined any documentation attached to the <br />certification to establish that the violations have been corrected, <br />3• Based ori my examination of they -attached documentation and inquiry of <br />the individuals who prepared or obtained it, I believe that the information <br />is true, accurate, and complete. <br />4. I am authorized to file this certification on behalf of the Respondent, <br />5. I am aware that there are significant penalties for submitting false <br />information, including the possibility of fine and imprisonment for knowing <br />violations, <br />5)V t i oil ?'r ocl � <br />st; 1 5 No`v� Dr <br />8V*-qV-n G 04kc D 2 0 U �, 15-0 <br />Facility Address EPA ID. Number <br />Name (Print or Type) <br />Signature <br />iDCERT (rev 1107/02) <br />Qw ws sue visor <br />Title <br />q <br />,21l2n(3DateSigned <br />I d �9Z0'IN Ad91:E X00 H 'unr <br />