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To: Robert Lopez San Joaquin County Env Page 35 of 36 2020-01-10 02:16:45(GMT) 12093709559 From:Griffin Materials <br /> San Joaquin County <br /> Environmental Health Department <br /> 3868 East Hazelton Avenue,Stockton,California 95205-6232 <br /> Telephone:(209)468-3420 Fax:(209)468-3433 Web:www,sjgov.crg ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> AnyIM NOR 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(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 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 results/manifestsltraining recordslother appropriate paperwork, and/or photos verifying <br /> corrections <br /> Inspection Date: June 16, 2017 Inspected By: ROBERT LOPEZ <br /> Facility Address: 248 INDUSTRIAL DR, STOCKTON CERS ID: ./C 740-2/-4 <br /> 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. l have personally examined the following documentation submitted as proof of compliance FOR EACH ViOLATION <br /> and I believe the information to be true, accurate, and complete: <br /> L--Photos 1--'—'Paperwork `-''' Statement <br /> 3. l am authorized to submit this certification on behalf of the Respondent. <br /> 4. l am aware that there are significant penalties for submitting false information,including the possibility of a fine <br /> and/or imprisonment for known violations. (HSC 25191) <br /> Name: t✓ `r. ^' �~1 > a? ,r�rsz��r Trtle: "�c, <br /> Signature: ,wwc u,�; Date: <br />