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San Joaquin County <br /> _ •Environmental Health Departments <br /> Ter1868 East Hazelton Avenue, Stockton, California 95205-6232 <br /> hone; (209) 68- 420 ax;(209) 68-3433 W b:www.sjc,ov.org/ehd <br /> M • � � • • • <br /> RETURN TO COMPLIANCE•CERTIF1 TIO41• <br /> • • • • • • • • <br /> Any MINOR violations noted in the"Notice to Comply" in the attached Inspection Report must be corrected within 30 days o� <br /> receipt of this inspection. This certfication form must be submitted to the Environmental Health Department(EJD) address <br /> at 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 t cegication and rtrid to Ewithin 30 days u s o sp fi t e <br /> Inspection Report. HSC 25185(c)(3) • <br /> .=e <br /> : All EHD staff time associated with fa_ ili � tolyby the aboye noted dates will be <br /> billed at the current hourly rates <br /> • • • <br /> For this certification to be complete, the operator of the site rreust include: <br /> • A statement documenting what corrective actions were taken or will be taken for each viol!.Ron • <br /> Copies of sample results/manifests/training records/other appropriate pa erwork, and/or photos verify`ng <br /> corrections <br /> I sp ction Datt June 25, 2018 IUpgct2d By: JOHN ALANIZ <br /> Facili A res 1325 EL PINA?DR, STOCKTON �CERS ID�o 0 <br /> I certif under penalty law := 1 • • <br /> 1 1 have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> Wil <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VICLATIGN <br /> and I believe the information to be tr acc ra e, and complete • <br /> y • • • • Photos Pa_i erwork •State= <br /> 3l am authorized to submit this certification on behalf of the Respondent. <br /> 4. am aware a ere are signs scan penalties for submitting false information, includiN the possibility o a fine <br /> and/or im risonment for known violations. HSC 25191 <br /> • <br /> Titl <br /> signature: Date: <br /> • <br />