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11/25/2015 PIED 11:22 FAX 2098704468 ServiCeAdminMFD <br />1014/014 <br />San Joaquin County <br />Environmental Health Department D G <br />1868 East Hazelton Avenue, Stockton, Callfornia 96205-6232 <br />Telephone: (209) 468-3420 Fax: (209) 468-3433 Web: www=sfgoy oralehd <br />NOV 2 5 ?i!,. <br />RETURN TO COMPLIANCE CERTIFICATIOV,RNMEN <br />TAL <br />HFAITN n, q R <br />Any MI violations noted in the "Notice to Comply" in the attached Inspection Report must be correc ed w�thir�b_iaD�s of <br />receipt of this inspection. This certification form must be submitted to the Environmental Health Department (EHD) address <br />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.3unless 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 billet <br />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 />Operator's certification <br />Inspectlon Date: July 20, 2015 <br />Facility Address: 2929 AUTO CENTER CIR <br />I certify under penalty of law that; <br />Inspected By: <br />Fatinah Zareef <br />1. 1 have corrected the violations specified In the Inspection Report from the above-mentioned Inspection date. <br />2. 1 have personally examined the following documentation submitted as proof of compliance FOR EACH VIOLATION s <br />I believe the Information to be true, accurate, and complete: <br />Photos _Paperwork ,Statement <br />3, 1 am authorized 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 possibility of a fine and/o <br />imprisonment for known violations. (HSC 25191) <br />