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Jul. 5. 201610:36AM No, 7808 P . la <br />• San Joaquin County • <br />NDED <br />Environmental Health Department <br />1868 East Hazelton Avenue, Stockton, California 95205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www.sigov.org/ehd <br />RETURN TO COMPLIANCE CERTIFICATION <br />Any MINOR violations noted in the "Notice to Comply" in the attached Inspection Report must be corrected within 30 days of <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHD) address; <br />the top of this form within 30 days of receipt of the Inspection Report, HSC 25404.1.2(c)(1) <br />All corrections to other violations noted in the attached Inspection Report (IR) or Continuation Form, or disputes to any <br />violations, are to be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the <br />Inspection Report. HSC 26185(c)(3) <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 to be complete, the operator of the site must include; <br />Astatement 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 verifying corrections <br />Inspection Date: _ May 20, 2016 Inspected By: ARIS VELOSO <br />Facility Address: 76115 AIRPORT WAY, STOCKTON EPA <br />I certify under penalty of law that: <br />1. 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br />believe the information to be true, accurate, and complete: <br />Photos Paperwork—Y—Statement <br />3'1 a rized to submit this certification on behalf of the Respondent. <br />4. 1 m a are at ere are significant penalties for submitting false information, including the possibility of a fine and/ <br />I ri nme for nown v 1 tions. (HSC 25191) <br />Nam <br />C.' Title: �P� "fir <br />Sianatuv: / Aln4— 1 /NYvV Date: <;'(� W [1-� <br />JUL 06 71) <br />