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Mar 1.1 15 09:48a ARP 12098352297 p.3 <br /> San Joaquin County <br /> Environmental Health Department <br /> 1 B68 East Hazelton Avenue, Stockton, California 95205-6232 MA, 1 1 2015 <br /> Telephone.(209)468-3420 Fax:(209)468-3433 Web:vrww.sj oq v.orglehd <br /> RETURN TO COMPLIANCE CERTIFICATION aN1CIRONMENTr. <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(EHO)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 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 resultslmanifeststtraining records/other appropriate paperwork;and/or photos verifying corrections <br /> Inspection Date: March 10, 2015 Inspected By: FATINAH ZAREEF <br /> Facility Address: 25775 S PATTERSON PASS RD, TRACY EPA ID- <br /> I <br /> o-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 pr f 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. i 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: �="�N AT F-- Titter1t'Z- <br /> Signature: Date: ° f <br />