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San Joaquin County <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue,Stockton, California 95205-6232 s <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web;www.sioov.org/ehdlZ <br /> i <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> b <br /> AnyIM NOR 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 25404.12(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 25185(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 /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training recordstother appropriate paperwork, and/or photos verifying corrections <br /> Inspection Date: July 06 2015 Inspected By: FATINAH ZAREEF <br /> Facility Address: 3282 AUTO CENTER OR, STOCKTON EPA ID: <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 /> I believe the information to be true,accurate, and complete: <br /> Photos Paperwork Statement <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 and/ <br /> imprisonment for known violations. (HSC 25191) <br /> Name: {h i( V1ctQ 1 QK1i 1 2 r Title:_ �c C 43 rY1an4��� <br /> '7 <br /> Signature: (�1t�.Vz S. r----- Date: <br />