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Mar 25 10 07:45a Apex Refrig 2093666882 p.1 <br /> 002454 <br /> SAN JOAQUIN COUNTY <br /> ENVIRONMENTAL HEALTH DEPARTMENT ... <br /> 600 East Main Street, Stockton, CA 95202-3029 <br /> TeleF'>one: (209)468-3420 Fax:(209) 468-3433 Web:www.siaov.oro/ei MAR 2 5 2010 •" <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 retumed 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. <br /> For this certification t0 be complete the operator of the site must include: <br /> • A statement documenting what corrective actions were taken or wiil be taken for each violation <br /> • Copies of sample results/manifests/training records/other appropriate paperwork, and/or photos <br /> verifying corrections <br /> • <br /> Operator's certification <br /> Inspection Date: 5 �l tl ) (� Inspected By: V, , C.Cct >-1 <br /> Facility Address: r,V\,C� f ltik� t C� EPA ID#:Ij <br /> 1 <br /> L od-� , gS2Kv <br /> certify under penalty of law that j <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 /> I <br /> _Photos_Paperwork X Statement I <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. <br /> I <br /> 4 1 am aware that there are significant penalties for submitting false information, including the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br /> Name' K�, kC (`(` C 1�6y\o L& Title: CQ f`AaiAacyr- <br /> Signature: Date- 25 10 <br /> EHD 22-02-005 Rev 08108 <br />