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Feb, 24. 2015 1 : 13FMN $436 P. <br /> = o, _ . 3. <br /> San Joaquin County HECE1VED <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton,Californla9520M232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web.www.slooy.org/ehd FEB 2 4 2015 <br /> RETURN TO COMPLIANCE CERTIFICATOWIRONMENTAL <br /> u1:4 BTU nr*onQTIAENT <br /> Any Mjig violations noted in the"Notice to Comply'In the attached Inspection Report must be corrected Wi in 30 days of <br /> receipt of this inspection. This certification form must be submitted to the Environmental Health Department(EHD)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 this certification and returned to EHD Within 30 days unless otherwise specified in the <br /> Inspection Repor#, HSC 26185(c)(3) <br /> x <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 s <br /> Copies of sample results/manifests/tralning records/other appropriate paperwork,and/or photos verifying <br /> corrections <br /> Inspection Date: February 18, 2015 Inspected By: MICHELLE HENRY <br /> Facility Address: 3408 MANTHEY RD, STOCKTON EPA ID. <br /> I certify under penalty of law that: <br /> e <br /> 1. 1 have corrected the violations specified In the Inspection Report from the above-mentioned Inspection date. <br /> C <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION <br /> E and I believe the information to be true,accurate,and complete: <br /> Photos .. Paperwork Statement d <br /> i Y <br /> 3. 1 am authorized to submit this certification on behalf of the Respondent. x <br /> 4- 1 am aware that[here are significant penalties for submitting false Information, including the possibility of a fine <br /> and/or imprisonment for known v ons. (HSG 26191) E <br /> Name: <br /> Title; -- c79� <br /> Slgn�ture: Date: <br /> a <br /> i <br /> .2 <br /> is <br /> E! <br /> 4 <br /> S <br /> z <br /> S d <br /> f a <br /> a <br /> + d <br />