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Ser) 18 13 11:18a Pro Lube 12095443637 PA <br /> Jep. I. Lull A308IH n JoaQu ? toualyN�. UO uu���� r. I <br /> SAN JOAQUIN COUNTY C E tl V <br /> ENVIRONMENTAL HEALTH DEPARTMENT 1 <br /> 1886 East Hazelton Avenue,Stockton, California 95245-6232 <br /> Telephone:(209)468-3420 Faw (209)488-3433 Web:www.s!oov.orate id S:P 16 2013 <br /> I <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the 'Notice to Comply' in the attached Inspection Report must be <br /> corrected within 30 days of receipt of this inspection- This certification farm 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. HSC 25404.1.2(c)(1) <br /> All wrreclions to other violations noted in the attached Inspectton Report(IR) or Continuation Form, or <br /> disputes to any violations, are to be submitted using this certification and returned to EHD within 30 days <br /> unless otherwise specified in the 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 t0 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 resultstmanffests/training records/other appropriate paperwork, and/or photos <br /> verifying corrections <br /> • Operator's certification <br /> Inspection Bate, /+L) I) q, ZQ Inspected By:Aris Cacapit <br /> Facility Address:808 S Cherokee Ln Lodi CA EPA ID#: CA-LaO2.C)_7 7&3 <br /> I certify under penalty of law that: <br /> t. I have corrected the violations specified in the Inspection Report from tim above-mentioned <br /> inspection data. <br /> 2. I have personally examined the following documentation submitted as proof of compliance FOR <br /> EACH VIOLATION and I believe the information to be,true, accurate,and complete: <br /> Photos_ ih Fapenvork Y Statement <br /> 3. 1 am authonzed to submit this certification on behalf of the Respondent. <br /> 4. 1 am aware that there are significant penalties for submitting false information, including the <br /> possibility of a fine and/or imprisonment for known violations. (HSC 25191) <br /> Name: ucov�_ Me: Wo4-C Xr <br /> Signature. Date: <br /> EHD 72-02-0Q7 flay O/i1W12 <br />