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65/23/2016 26:24 5107963470 SHARMA PAGE 03 <br /> San Joaquin County <br /> Environmental Health Department •wok G ,..� <br /> 1868 East Hazelton Avenue, Stockton, California 96205-6232 <br /> Telephone:(209)4683420 Fax:(209)468-3433 Web:Wftsigov. Wtod MAY 2 4 2016 <br /> RETURN TO COMPLIANCE CERTIFICATION y � ."'►"_'�_ <br /> Any MINOR violations noted in the`Notice to Comply"in the attached inspection Report must be corrected within -;n d <br /> receipt of this inspection. This certification form must be submitted to the Environmental He* h Department(.EHD)add a sf 1 <br /> the top of this form within 30 days of receipt of the Inspection Report NSC 254041.2(c)(1)All gorre on_ to ojher 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 wAhin 30 dans un*s otherwise specified in the <br /> Inspection Report. HSC 25185(c)(3) <br /> Note: All END staff time associated with failing to comply by the above noted date$will be <br /> billed at the current hourly rate. <br /> For this certification to be complete, the operator of the site must include. <br /> A statement documenting what corrective actions were taken or will be taken for each violation <br /> Copies of sample results/manifests/training records/other appropriate paperwork,and or photos verifying corrections <br /> In$pection Date: March 14, 2016 Inspected By. ELENA MANZO <br /> Facility Address: 1100S MAIN ST MANTE CA EPA l[X C-A <br /> I certify under penalty of law that: H <br /> 1. I have corrected the violations specified in the In-,lection Report from the above-meet ned inspection date, <br /> 2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH"OLATION <br /> I believe the information to be true,accurate,and complete: <br /> -Photos .- '-K' P rv+rc�rk 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, includirg the possibility of a fine and/ <br /> imprisonment for known violations. (HSC 25191 <br /> (Name: } ' ��'�:t;r �H r th, Tt#Ie: f',�.t,7"D <br /> Signature: ��' -- <br /> ��;• Date: <br />