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RECEIVED <br /> SAN JOAQUIN SEP 24 2019 <br /> COUNTY <br /> ENVIRONMENTAL HEALTH <br /> PERMIT/SERironmental Health Department <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the"Notice to Comply"in the-attached Inspection Report must be corrected within 30 days of receipt of <br /> this inspection.This certification form must be submitted to the Environmental Health Department(EHD)address at the bottom of this <br /> 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 violations,are to <br /> be submitted using this certification and returned to EHD within 30 days unless otherwise specified in the Inspection Report.HSC <br /> 25185(c)(3) <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be billed at the current <br /> 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 • Operator's <br /> certification <br /> Inspection Date: September 05, 2019 Inspected By: ROBERT LOPEZ <br /> Facility Address: 2000 STIMSON RD, STOCKTON CERS ID: 10181267 <br /> I certify under penalty of law that: <br /> 1. I have corrected the violations specified in the Inspection Report from the above-mentioned inspection date. <br /> 2. I have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION and 1 <br /> believe the information to be true,accurate,and complete: <br /> Photos 3 `Paperwork Statement <br /> 3. I 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/o <br /> imprisonment for known violations. (HSC 25191) <br /> Name: 19C,., 1Mu .,�-e� aANU ltJ Q Title: <br /> Signature: Date: 23 Oer�T ' ►O (t <br /> SAN JOAQUIN <br /> rC_UNTY <br /> Environmental Health Department <br />