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09/14/2010 13:57 4082622206 PANDCAUTO PAGE 05/06 <br /> SAN JOAQUiN COUNTY <br /> ENVIRONMENTAL 1..i13ALTI I DEPARTMENT <br /> 600 E.Main St., Stockton,CA 95202-3029 <br /> Telephone:(209)4.68-3420 Fax:(209)468-3433 Web:www.sigovgrWAtd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR violations noted in the "Notice to Comply"in the attached Inspection Report must be <br /> corrected wi.tbi.n 30 days of receipt of this inspection. This certification.form must be submitted to the <br /> Envirormiaental lleal.th Department(EHD) address at the top of this form within 35 days of receipt of the <br /> Inspection Report. <br /> All corrections to other violations noted. in the attached Inspection Report 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. <br /> Note: All EHD staff time associated with failing to comply by the above noted dates will be billed at <br /> the current hourly rate($105). <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 results/manifests/training,records/other appropriate paperwork, and/or photos <br /> verifying corrections <br /> • Operator's certification. <br /> Inspection Date: r (� l D Inspected By: Z+(SS <br /> Facility Address: EPA ID#: CI L 000 6Bb5:2— <br /> I certify under penalty of law that: <br /> 1. 1 have corrected the violations specified in the inspection Report from the above-mentioned <br /> inspection date. <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 Paperwork K Statement <br /> 3. I am authorized to submit this certification on behalf of the Respondent. <br /> 4. lam aware that there are significant penalties for submitting false information, including the <br /> possibility of a fure and/or imprisonment for known violations. (HSC 25191) <br /> nn �. <br /> Name: lit Keo 1 r ao, �L -Title: G1 , <br /> Signature: <br /> EHD 22-02-005 Rev 10-07 <br />