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COMPLIANCE INFO_2020
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1900 - Hazardous Materials Program
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PR0527688
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COMPLIANCE INFO_2020
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Last modified
4/13/2020 3:17:13 PM
Creation date
4/13/2020 3:16:35 PM
Metadata
Fields
Template:
EHD - Public
ProgramCode
1900 - Hazardous Materials Program
File Section
COMPLIANCE INFO
FileName_PostFix
2020
RECORD_ID
PR0527688
PE
1921
FACILITY_ID
FA0018576
FACILITY_NAME
Reddaway
STREET_NUMBER
1495
Direction
E
STREET_NAME
PESCADERO
STREET_TYPE
Ave
City
Tracy
Zip
95304
APN
213-060-26
CURRENT_STATUS
01
SITE_LOCATION
1495 E Pescadero Ave
P_LOCATION
03
P_DISTRICT
005
QC Status
Approved
Scanner
SJGOV\dsedra
Tags
EHD - Public
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RECEIVED <br /> .IAN 1 � <br /> San Joaquin County ENVJRONiNIFNT:�L IIE,�L"1 11 <br /> Environmental Health Department <br /> 1868 East Hazelton Avenue, Stockton, California 95205-6232 I)I.1'.-�K"I"i11 h;N"I' <br /> Telephone:(209)468-3420 Fax: (209) 468-3433 Web:www.sogov.org/ehd <br /> RETURN TO COMPLIANCE CERTIFICATION <br /> Any MINOR 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/manifests/training records/other appropriate paperwork, and/or photos verifying <br /> corrections <br /> Operator's certification <br /> Inspection Date: June 14, 2019 Inspected By: Robert Lopez <br /> Facility Address: 530 PORT OF STOCKTON EXPY CERS ID: 10186969 <br /> 1 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. 1 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 /> 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 <br /> and/or imprisonment for known violations. (HSC 25191) <br /> Name: A�ff"v Title: -� <br /> Signature: Date: <br />
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