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.N JOAQUIN COUNTY UNIFIED r—OGRAM AGENCY 'i213� <br /> VVIRONMENTAL HEALTH DIVISIUN <br /> ]4 E.WEBER AVENUE J <br /> TOCKTON, CA 95202 ` <br /> CERTIFICATION OF RETURN TO COMPLIANCE <br /> For Hazardous Waste Generators <br /> In the matter of the Violation cited on: 2� 0 <br /> As Identified in the Inspection Report dated 2 <br /> Conducted by: [EHD Inspector(s)] <br /> I certify under penalty of law that: <br /> 1. Respondent has corrected the violations specified in the notice of violation cited <br /> above. <br /> 2. I have personally examined any documentation attached to the certification to <br /> establish that the violations have been corrected. <br /> 3. Based on my examination of the attached documentation and inquiry of the <br /> individuals who prepared or obtained it, I believe that the information is true, <br /> accurate, and complete. <br /> 4. 1 am authorized to file this certification on behalf of the Respondent. <br /> 5. I am aware that there are significant penalties for submitting false information, <br /> including the possibility of fine and imprisonment for knowing violations. <br /> f <br /> Nami1nt or Type) Title <br /> Za�3 <br /> Si / ature Date Signed <br /> Company Name <br /> -- n%4V(`RT!R/001 <br />