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SAN JOAQUIN COUNTY UNIFT 1 PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DE, ,ARTMENT <br /> 304 E. WEBER AVENUE <br /> STOCKTON, CA 95202 <br /> SEL <br /> �D <br /> CERTIFICATION OF RETURN TO COMP FC-2 0 2005 <br /> TENT HEALTH <br /> For Hazardous Waste Generators PEPP'1iT/SEM,/1OES <br /> ?n the matter of the Violation cited at: P?- �> <br /> As Identified in the Inspection Report dated on:q-L\ - � <br /> 1 _ <br /> Conducted by: [EHD Inspector(s)] <br /> I certify under penalty of-law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2. I have personally examined any documentation attached to the <br /> certification to establish that the violations have been-corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of <br /> the individuals who prepared or obtained it, I believe that the information <br /> is true, accurate, and complete. <br /> 4. I am authorized to file this certifcatien on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing <br /> violations. <br /> $80 vic.+or Rol. <br /> zr <br /> Facility Address EPA ID. Number t©o k <br /> Name (Print or Type) Title <br /> RIO 21 <br /> a - <br /> SignaW Date Sig ed <br /> EHDCERT(rev 1/07/02) <br />