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San Joaquin county <br /> Environmental Health Department <br /> 1668 East Hazelton Avenue209 468-3433 California <br /> 9^N^ sb— o°---v orOlehd <br /> Telephone:(209)468-3420 Fax: ( ) <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> orre <br /> Any MINOR violations noted in the"Notice to Comply" in the attached Inspection Report must Health <br /> Department <br /> within 30 dare s <br /> 2 c)(1) <br /> receipt of this inspection. This certification of receipt rce pt of the Insp�e submitted to ecti n Report t e Environmental Heppalth Department(EHD) address <br /> the top of this form within 30 day �L � ��ps es to any <br /> usn this certification and returned to EHD within 30 da ddds???un l... [ specified in the <br /> All correction to other violations noted in the attached Inspection Report(1�3 2016 �C:� <br /> violations, are to be submitted9 <br /> Inspection Report. HSC 25185(c)(3) <br /> Eabove noted dates will be <br /> Note: All EHD staff time associated with failing t � PAENTAL ENTAL <br /> RTMEHEALTH <br /> billed at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include <br /> o riate paperwork, and/or p <br /> hotos verifying corrections <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 app Inspected By: STACY RIVERA <br /> Inspection Date: Jul 12. 2016 EPA ID <br /> Facility Address: 18754 E HWY 26 , LINDEN <br /> anal of law that: <br /> I certify under penalty <br /> 1_ 1 have corrected the violations specified in the Inspection Report from the above-7nedinos date. <br /> 2. I have personally examined the following documentation subemiitted as proof of cVIOLATIONand I believe the information to be true, accurate, a9d comp /Photos V// Paperwork v Stateme <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 possibility of a fine <br /> and/or imprisonment for known <br /> /violations (HSC 25191) / <br /> Name: Jly! d��� Title: <br /> Date: - ZO /01 <br /> Signatur <br /> Seg 4 f(tt C�� i Gt) <br /> P� twc,2ic. y���s� 1-V Qu NS �s�uo� —P� �l�e�s quo 9Qsolr�� <br /> rllerS —rte 6 j 4ere 4!( (i erre`tWI47 <br /> AZA 60d- 5 � g � {o <br />