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Aug. 1. 2412 2:42PM G eke Toyota Parts No, 3651 P. 1 <br /> 042454 <br /> : JS <br /> .,,AN,4QAQgIN COUNTY <br /> ENVIF,t6NMEr rAir HE LTk OEPAE flAENT b <br /> 60Q E"a .IAflsin, <br /> . 30 9 <br /> Teli�.iohe.{209)468-3420 Fa 206) $-3433 INeb Wm§jgov.om1ehdn <br /> .� ,....fr r( �'-f'M i 20l <br /> t"' <br /> RETURN TO COMPLIANCE CERTiFICATION`;-,L L �f <br /> Any INOR violations noted,in the"Notice to Comply,In the attached Inspection Report must be <br /> correct6d within N 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 correpliopg Ig other violations noted in the attached Inspection Report(IR) or Continuation Form, or <br /> disputes to;iany violatioris, are to be submitted using this certification and returned to EHt) ithin 30 days, <br /> unless otherwise specified in the inspection Report, <br /> Note: All EHO 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 /> Y 'A statement documenting what corrective actions were takers or will be taken for each violation <br /> • Copies of sample resultslmanifests/train'Ing recordsiother app"ropriate paperwork, andlor photos <br /> 'verifying corrections <br /> O pstator's certificat' n <br /> inspection Date; <br /> Inspected Bys. fidl <br /> r <br /> Facility Address:AW ( /d EPA l :_4AI, <br /> ! certify under penalty.of Ipw that:: <br /> • l <br /> I <br /> 1. i have corrected the violations specified in the Inspection Report from the above-mentioned <br /> inspection date. <br /> f <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH ViOL,ATiON and I believe the:informatiorrto be true accurate, and complete: <br /> Photos ,,,,,� <br /> �'4 Paperwork Statement <br /> 3. i am authorized to submit this certification on behalf of the Respondent. <br /> f 4 i am aware that there are significant penalties for submitting false information, including the ` <br /> possibility of a fi a andlor im risonment for known violations. (HSC 25199) <br /> ,f� I <br /> Name: f 1� ! Title: r <br /> Signator / , <br /> Date• � <br /> EHD 22.02.003 RAV 08/08 <br />