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SAN JOAQUIN COUNTY UNIF.,_O PROGRAM AGENCY <br /> ENVIRONMENTAL HEALTH DEPARTMENT <br /> 304 E.WEBER AVENUE <br /> STOCKTON, CA 95202 <br /> SEP 0 `� 2003 <br /> RONME�� NEA1-j H <br /> CERTIFICATION OF RETURN TO COMPLIA IERMjjS0N10ES <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on : -506Z 90M iav <br /> As Identified in the Inspection Report dated <br /> Conducted by: C [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation <br /> cited above. <br /> 2. I have personally examined any documentation attached to the <br /> certification to establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of <br /> the individuals who prepared or obtained it, I believe that the information <br /> is true, accurate, and complete. <br /> 4. I am authorized to file this certification on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false <br /> information, including the possibility of fine and imprisonment for knowing <br /> violations. <br /> sea �l 1� 014L ono 16 s�ry <br /> Facility Address EPA ID. Number <br /> Q'�- splytl�e <br /> Name (Print or Type) Title <br /> Signature Date Signed <br /> EHDCERT(rev 1/07/02) <br />